Morphometric Differences between the Medial and Lateral Meniscus in Healthy Men – A Three-Dimensional Analysis Using Magnetic Resonance Imaging

Abstract

The objective of this work was to characterize tibial plateau coverage and morphometric differences of the medial (MM) and lateral meniscus (LM) in a male reference cohort using three-dimensional imaging. Coronal multiplanar reconstructions of a sagittal double-echo steady state with water excitation magnetic resonance sequence (slice thickness: 1.5 mm, and in-plane resolution: 0.37 × 0.70 mm) were analyzed in 47 male participants without symptoms, signs or risk factors of knee osteoarthritis of the reference cohort of the Osteoarthritis Initiative. The medial and lateral tibial (LT) plateau cartilage area and the tibial, femoral and external surfaces of the MM and LM were manually segmented throughout the entire knee. This process was assisted by parallel inspection of a coronal intermediately weighted turbo spin echo sequence. Measures of tibial coverage, meniscus size, and meniscus position were computed three-dimensionally for the total menisci, the body, and the anterior and the posterior horn. The LM was found to cover a significantly greater (p < 0.001) proportion of the LT plateau (59 ± 6.8%) than the MM of the medial plateau (50 ± 5.5%). Whereas the volume of both menisci was similar (2.444 vs. 2.438 ml; p = 0.92), the LM displayed larger tibial and femoral surface areas (p < 0.05) and a smaller maximal (7.2 ± 1.0 vs. 7.7 ± 1.1 mm; p < 0.01) and mean thickness (2.7 ± 0.3 vs. 2.8 ± 0.3 mm; p < 0.001) than the medial one. Also, the LM displayed less (physiological) extrusion than the medial one. These data may guide strategies for meniscal tissue engineering and transplantation aiming to restore normal joint conditions.

Imaging research results from the Osteoarthritis Initiative (OAI): a review and lessons learned 10 years after start of enrolment

“…Intraobserver111 112 and interobserver reliability113 were satisfactory for manual segmentation using coronal DESS (figure 1E), with reasonable agreement to conventional clinical sequences113 (table 3). …”

“…The meniscus covered 50% of the tibia medially and 58% laterally111 in healthy knees, with no differences between men and women 115. Medial tibial coverage by the meniscus was only 36% in JSN1 and 31% in JSN2/3 knees, and 45% in contralateral knees without JSN 116.…”

Quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis – data from the Osteoarthritis Initiative

“…We recently developed three dimensional quantitative measurement technology using MRI to determine meniscus size, shape, and position relative to the tibial plateau cartilage 18–20 . Using this technique we showed previously that measures of medial meniscus extrusion were increased and tibial coverage was decreased in knees with medial radiographic joint space narrowing (JSN) 11 , compared with contra-lateral knees without JSN 11 , and compared with healthy reference knees 19 .…”

Effect of Sagittal Allograft Position on Coronal Extrusion in Lateral Meniscus Allograft Transplantation

“…However, a recent study showed that the morphology and meniscus position on weight-bearing and noneweight-bearing MRI studies differed minimally. 25 Moreover, lateral meniscus extrusion did not differ significantly for patients placed in a supine noneweight-bearing position, a unipodal stance, and a bipodal stance in 10 adults assessed with ultrasound. 20 Another limitation of our study may be the difficulty encountered in assessing the margins of the anterior and posterior horns on MRI because of a partial-volume effect, in which meniscal tissue may have overlapped with the anterior and posterior margins of the tibial plateau.…”

“…This limitation may have decreased the accuracy of the measurements of MRI parameters, such as CAMD or CPMD. 25 However, the reliability values for the MRI parameter measurements were found to be satisfactory (ICC >0.75). This study was also a retrospective, matched control study and therefore may have had inherent recall or recruitment bias.…”