Tibial coverage, meniscus position, size and damage in knees discordant for joint space narrowing – data from the Osteoarthritis Initiative

Abstract

SUMMARY Introduction Meniscal extrusion is thought to be associated with less meniscus coverage of the tibial surface, but the association of radiographic disease stage with quantitative measures of tibial plateau coverage is unknown. We therefore compared quantitative and semi-quantitative measures of meniscus position and morphology in individuals with bilateral painful knees discordant on medial joint space narrowing (mJSN). Methods A sample of 60 participants from the first half (2,678 cases) of the Osteoarthritis Initiative cohort fulfilled the inclusion criteria: bilateral frequent pain, Osteoarthritis Research Society International (OARSI) mJSN grades 1–3 in one, no-JSN in the contra-lateral (CL), and no lateral JSN in either knee (43 unilateral mJSN1; 17 mJSN2/3; 22 men, 38 women, body mass index (BMI) 31.3 ± 3.9 kg/m2). Segmentation and three-dimensional quantitative analysis of the tibial plateau and meniscus, and semi-quantitative evaluation of meniscus damage (magnetic resonance imaging (MRI) osteoarthritis knee score – MOAKS) was performed using coronal 3T MR images (MPR DESSwe and intermediate-weighted turbo spin echo (IW-TSE) images). CL knees were compared using paired t-tests (between-knee, within-person design). Results Medial tibial plateau coverage was 36 ± 9% in mJSN1 vs 45 ± 8% in CL no-JSN knees, and was 31 ± 9% in mJSN2/3 vs 46 ± 6% in no-JSN knees (both P < 0.001). mJSN knees showed greater meniscus extrusion and damage (MOAKS), but no significant difference in meniscus volume. No significant differences in lateral tibial coverage, lateral meniscus morphology or position were observed. Conclusions Knees with medial JSN showed substantially less medial tibial plateau coverage by the meniscus. We suggest that the less meniscal coverage, i.e., less mechanical protection may be a reason for greater rates of cartilage loss observed in JSN knees.

Three‐dimensional mapping of the joint space for the diagnosis of knee osteoarthritis based on high resolution computed tomography: Comparison with radiographic, outerbridge, and meniscal classifications

“…In a previous study, with double contrast macro‐radiographs, it was demonstrated that in the medial compartment, articular cartilage damage of the tibia was markedly attached to meniscal damage contrary to femoral cartilage 41. One of the limitations of our study is that we performed only cartilage measurements at the tibia because it was demonstrated that tibial coverage by the meniscus and femur cartilage thickness explained 80% of the variability of joint space width 42. The Kellgren Lawrence classification is known to have low reproducibility and moderate sensitivity 43.…”

Radiological Pain Predictors in Knee Osteoarthritis, a Four Feature Selection Comparison: Data from the OAI

“…The Osteoarthritis Research Society International (OARSI) assessment scale of knee OA [15,16], have been adopted as a standard in many health systems and OA studies around the world. Measured by these scales, Joint Space Width (JSW) is commonly associated with OA stages [17,18], this measurements helps to see the density of the cartilage and the loss of it.…”

Postoperative change in medial meniscal length in concurrent all-inside meniscus repair with anterior cruciate ligament reconstruction

“…Meniscal sizing is important in evaluating meniscal damage, extrusion, movement and tibial plateau coverage by the meniscus [1,2]. Pre-operative size matching of the meniscus is also critical for successful meniscal allograft transplantation [3].…”