Meniscal Root Tears and Extrusion Are Significantly Associated with the Development of Accelerated Knee Osteoarthritis: Data from the Osteoarthritis Initiative

Abstract

Objective To identify joint structural risk factors, measured using quantitative compositional and semiquantitative magnetic resonance imaging (MRI) scoring, associated with the development of accelerated knee osteoarthritis (AKOA) compared with a more normal rate of knee osteoarthritis (OA) development. Design From the Osteoarthritis Initiative we selected knees with no radiographic OA (Kellgren-Lawrence grade [KL] 0/1) that developed advanced-stage OA (KL 3/4; AKOA) within a 4-year timeframe and a comparison group with a more normal rate of OA development (KL 0/1 to KL 2 in 4 years). MRIs at the beginning of the 4-year timeframe were assessed for cartilage T2 values and structural abnormalities using a modified Whole-Organ Magnetic Resonance Imaging Score (WORMS). Associations of MRI findings with AKOA versus normal OA were assessed using multivariable logistic regression models. Results A total of 106 AKOA and 168 subjects with normal OA development were included. Mean cartilage T2 values were not significantly associated with AKOA (odds ratio [OR] 1.06; 95% confidence interval [CI] 0.82-1.36). Risk factors for AKOA development included higher meniscus maximum scores (OR 1.37; 95% CI 1.11-1.68), presence of meniscal extrusion (OR 6.30; 95% CI 2.57-15.49), presence of root tears (OR 4.64; 95% CI 1.61-13.34), and higher medial tibia cartilage lesion scores (OR 1.96; 95% CI 1.19-3.24). Conclusions We identified meniscal damage, especially meniscal extrusion and meniscal root tears as risk factors for AKOA development. These findings contribute to identifying subjects at risk of AKOA at an early stage when preventative measures targeting modifiable risk factors such as meniscal repair surgery could still be effective.

Effects of Angular Resolution and b Value on Diffusion Tensor Imaging in Knee Joint

“…Proteoglycan depletion, collagen fiber degradation, and water content increase are observed during the progress of OA. 39,40 Although conventional MRI is relatively insensitive for early OA detection, recent advances of quantitative MRI have improved its ability to evaluate biochemical components in articular cartilage. 8,41-43 Besides the quantitative measurements based on relaxation times, MD and FA derived from DTI are 2 promising biomarkers for early OA.…”

A 2021 consensus statement on osteotomies around the knee by the UK Knee Osteotomy consensus Group (KOG)

“…The menisci are essential to the normal biomechanical function of the knee joint [16]. Meniscus loss can also be functional; when there is loss of meniscus integrity and hoop stresses, resulting in increased contact pressure on the articular cartilage [17]. Meniscus degeneration, radial and root tears can result in meniscus extrusion with consequent loss of function equivalent to total meniscectomy [18].…”

Clinical significance and management of meniscal extrusion in different knee pathologies: a comprehensive review of the literature and treatment algorithm

“…Therefore, ultrasound (U/S) was recently introduced as a reliable alternative to MRI for the evaluation of ME, which also offers the possibility for dynamically assessing ME in various positions, as well as in a weight-bearing state, in an inexpensive and feasible manner [ 20 – 22 ]. Interest in ME has grown exponentially in recent years, as it is associated with several pathologies, such as knee OA, meniscal posterior root tears (MPRT), post-anterior cruciate ligament reconstruction (ACLR) and post-meniscal allograft transplantation (MAT) [ 6 , 23 , 24 ]. More importantly, it leads to rapid progression of the degenerative process of the knee as well as substantial morbidity and pain [ 25 – 28 ].…”