Meniscus body position and its change over four years in asymptomatic adults: a cohort study using data from the Osteoarthritis Initiative (OAI)

BMC Musculoskeletal Disorders

Martin Englund¹  Felix Eckstein⁴  Ali Guermazi²  Wolfgang Wirth⁴  Aleksandra Turkiewicz³  Fredrik Svensson³  Katharina Bruns⁵ 

[1] Clinical Epidemiology Research & Training Unit, Boston University School of Medicine, Boston, MA, USA;Department of Radiology, Boston University School of Medicine, Boston, MA, USA;Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden;Chondrometrics GmbH, Ainring, Germany;Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria

关键词: Osteoarthritis;    Magnetic resonance imaging;    Meniscus;    Knee;   

Others  :  1128852
DOI  :  10.1186/1471-2474-15-32

 received in 2013-08-30, accepted in 2014-02-04,  发布年份 2014

【 摘 要 】

Background

A high degree of meniscal body extrusion on knee magnetic resonance imaging has been shown to be strongly associated with development of knee osteoarthritis. However, very little is known about meniscal position in the asymptomatic knee and its natural history. Hence our objective was to study meniscal body position and its change over 4 years in asymptomatic adults.

Methods

Cohort study using data from the Osteoarthritis Initiative (OAI) involving four clinical sites in the United States (Baltimore, Maryland, Pawtucket, Rhode Island, Columbus, Ohio, and Pittsburgh, Pennsylvania). We studied both knees from 118 subjects (mean age 55 years, 61% women, mean body mass index 24.4) from the OAI “non-exposed” reference cohort free of knee pain, radiographic knee osteoarthritis and risk factors for knee osteoarthritis at baseline. We assessed mid-coronal intermediate-weighted 3-Tesla magnetic resonance images from baseline and the 2- and 4-year follow-up visit. One observer measured tibia plateau, meniscal body width and meniscal body extrusion in both compartments. We calculated meniscal overlap distance on the tibial plateau, % coverage, and extrusion index compared to tibia width. Potential trends in position over the 4-year period were evaluated using a linear mixed-effects regression model.

Results

The mean (SD) values at baseline for medial meniscal body extrusion and overlap distance were 1.64 mm (0.92) and 10.1 mm (3.5), and coverage was 34.4% (11.9). The corresponding values for the lateral compartment were 0.63 mm (0.73), 9.8 mm (2.4), and 31.0% (7.7). Medial meniscus body extrusion index was greater in female knees (p = 0.03). There was slight increase in medial meniscal body extrusion over 4 years (0.040 mm/year [95% CI: 0.019-0.062]). The other variables were relatively stable.

Conclusions

In asymptomatic adults, the relative degree of meniscus body extrusion is more pronounced in female knees. Although a slight increase in extrusion over time was noted for the medial body, positions were relatively stable within subjects over time.

【 授权许可】

   
2014 Bruns et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Kurosawa H, Fukubayashi T, Nakajima H: Load-bearing mode of the knee joint: physical behavior of the knee joint with or without menisci. Clin Orthop Relat Res 1980, 149:283-290.
• [2]Walker PS, Erkman MJ: The role of the menisci in force transmission across the knee. Clin Orthop Relat Res 1975, 109:184-192.
• [3]Andrews S, Shrive N, Ronsky J: The shocking truth about meniscus. J Biomech 2011, 44(16):2737-2740.
• [4]Hsu RW, Himeno S, Coventry MB, Chao EY: Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res 1990, 255:215-227.
• [5]Harner CD, Mauro CS, Lesniak BP, Romanowski JR: Biomechanical consequences of a tear of the posterior root of the medial meniscus. Surgical technique. J Bone Joint Surg Am 2009, 91(Suppl 2):257-270.
• [6]Bae JY, Park KS, Seon JK, Kwak DS, Jeon I, Song EK: Biomechanical analysis of the effects of medial meniscectomy on degenerative osteoarthritis. Med Biol Eng Comput 2012, 50(1):53-60.
• [7]Gale DR, Chaisson CE, Totterman SM, Schwartz RK, Gale ME, Felson D: Meniscal subluxation: association with osteoarthritis and joint space narrowing. Osteoarthritis Cartilage 1999, 7(6):526-532.
• [8]Kenny C: Radial displacement of the medial meniscus and Fairbank’s signs. Clin Orthop Relat Res 1997, 339:163-173.
• [9]Sugita T, Kawamata T, Ohnuma M, Yoshizumi Y, Sato K: Radial displacement of the medial meniscus in varus osteoarthritis of the knee. Clin Orthop Relat Res 2001, 387:171-177.
• [10]Englund M, Guermazi A, Roemer FW, Aliabadi P, Yang M, Lewis CE, Torner J, Nevitt MC, Sack B, Felson DT: Meniscal tear in knees without surgery and the development of radiographic osteoarthritis among middle-aged and elderly persons: the Multicenter Osteoarthritis Study. Arthritis Rheum 2009, 60(3):831-839.
• [11]Englund M, Guermazi A, Roemer FW, Yang M, Zhang Y, Nevitt MC, Lynch JA, Lewis CE, Torner J, Felson DT: Meniscal pathology on MRI increases the risk for both incident and enlarging subchondral bone marrow lesions of the knee: the MOST study. Ann Rheum Dis 2010, 69(10):1796-1802.
• [12]Hunter DJ, Zhang YQ, Niu JB, Tu X, Amin S, Clancy M, Guermazi A, Grigorian M, Gale D, Felson DT: The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis. Arthritis Rheumatism 2006, 54(3):795-801.
• [13]Wenger A, Englund M, Wirth W, Hudelmaier M, Kwoh K, Eckstein F, Investigators OAI: Relationship of 3D meniscal morphology and position with knee pain in subjects with knee osteoarthritis: a pilot study. Eur Radiol 2012, 22(1):211-220.
• [14]Costa CR, Morrison WB, Carrino JA: Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? AJR Am J Roentgenol 2004, 183(1):17-23.
• [15]Allen DM, Crema MD, Marra MD, Guermazi A, Wyman BT, Hellio Le Graverand MP, Englund M, Brandt KL, Hunter DJ: The relationship between meniscal tears and meniscal positioning. Ther Adv Musculoskel Dis 2010, 2(6):315-323.
• [16]Crema MD, Roemer FW, Felson DT, Englund M, Wang K, Jarraya M, Nevitt MC, Marra MD, Torner JC, Lewis CE, et al.: Factors associated with meniscal extrusion in knees with or at risk for osteoarthritis: the multicenter osteoarthritis study. Radiology 2012, 264(2):494-503.
• [17]Stone KR, Freyer A, Turek T, Walgenbach AW, Wadhwa S, Crues J: Meniscal sizing based on gender, height, and weight. Arthroscopy 2007, 23(5):503-508.
• [18]Bloecker K, Englund M, Wirth W, Hudelmaier M, Burgkart R, Frobell RB, Eckstein F: Revision 1 size and position of the healthy meniscus, and its correlation with sex, height, weight, and bone area- a cross-sectional study. BMC Musculoskelet Disord 2011, 12:248. BioMed Central Full Text
• [19]Englund M, Guermazi A, Gale D, Hunter DJ, Aliabadi P, Clancy M, Felson DT: Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 2008, 359(11):1108-1115.
• [20]De Smet AA, Tuite MJ: Use of the “two-slice-touch” rule for the MRI diagnosis of meniscal tears. AJR Am J Roentgenol 2006, 187(4):911-914.
• [21]Nevitt MC, Peterfy C, Guermazi A, Felson DT, Duryea J, Woodworth T, Chen H, Kwoh K, Harris TB: Longitudinal performance evaluation and validation of fixed-flexion radiography of the knee for detection of joint space loss. Arthritis Rheumatism 2007, 56(5):1512-1520.
• [22]Iranpour-Boroujeni T, Li J, Lynch J, Nevitt M, Duryea J: A new method to measure anatomic knee alignment: a tool for large studies of OA? Osteoarthr Cartil 2012, 20(Suppl 1):S20.
• [23]Felson DT, Cooke TD, Niu J, Goggins J, Choi J, Yu J, Nevitt MC, Group OAII: Can anatomic alignment measured from a knee radiograph substitute for mechanical alignment from full limb films? Osteoarthr Cartil 2009, 17(11):1448-1452.
• [24]Hunter DJ, Guermazi A, Lo GH, Grainger AJ, Conaghan PG, Boudreau RM, Roemer FW: Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score). Osteoarthr Cartil 2011, 19(8):990-1002.
• [25]Hunter DJ, Lo GH, Gale D, Grainger AJ, Guermazi A, Conaghan PG: The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston Leeds Osteoarthritis Knee Score). Ann Rheum Dis 2008, 67(2):206-211.
• [26]Roemer FW, Nevitt MC, Felson DT, Niu J, Lynch JA, Crema MD, Lewis CE, Torner J, Guermazi A: Predictive validity of within-grade scoring of longitudinal changes of MRI-based cartilage morphology and bone marrow lesion assessment in the tibio-femoral joint–the MOST study. Osteoarthr Cartil 2012, 20(11):1391-1398.
• [27]Stone KR, Stoller DW, Irving SG, Elmquist C, Gildengorin G: 3D MRI volume sizing of knee meniscus cartilage. Arthroscopy 1994, 10(6):641-644.
• [28]Wirth W, Frobell RB, Souza RB, Li X, Wyman BT, Le Graverand MP, Link TM, Majumdar S, Eckstein F: A three-dimensional quantitative method to measure meniscus shape, position, and signal intensity using MR images: a pilot study and preliminary results in knee osteoarthritis. Magn Reson Med 2010, 63(5):1162-1171.
• [29]Bowers ME, Tung GA, Fleming BC, Crisco JJ, Rey J: Quantification of meniscal volume by segmentation of 3 T magnetic resonance images. J Biomech 2007, 40(12):2811-2815.
• [30]Bloecker K, Wirth W, Hudelmaier M, Burgkart R, Frobell R, Eckstein F: Morphometric differences between the medial and lateral meniscus in healthy men - a three-dimensional analysis using magnetic resonance imaging. Cells Tissues Organs 2012, 195(4):353-364.
• [31]Jones RS, Keene GC, Learmonth DJ, Bickerstaff D, Nawana NS, Costi JJ, Pearcy MJ: Direct measurement of hoop strains in the intact and torn human medial meniscus. Clin Biomech 1996, 11(5):295-300.
• [32]Wenger A, Wirth W, Hudelmaier M, Noebauer-Huhmann I, Trattnig S, Bloecker K, Frobell RB, Kwoh CK, Eckstein F, Englund M: Meniscus body position, size, and shape in persons with and persons without radiographic knee osteoarthritis: quantitative analyses of knee magnetic resonance images from the osteoarthritis initiative. Arthritis Rheumatism 2013, 65(7):1804-1811.
• [33]Jung KA, Lee SC, Hwang SH, Yang KH, Kim DH, Sohn JH, Song SJ, Hunter DJ: High frequency of meniscal hypertrophy in persons with advanced varus knee osteoarthritis. Rheumatol Int 2010, 30(10):1325-1333.
• [34]Englund M, Felson DT, Guermazi A, Roemer FW, Wang K, Crema MD, Lynch JA, Sharma L, Segal NA, Lewis CE, et al.: Risk factors for medial meniscal pathology on knee MRI in older US adults: a multicentre prospective cohort study. Ann Rheum Dis 2011, 70(10):1733-1739.
• [35]Felson DT, Nevitt MC: Blinding images to sequence in osteoarthritis: evidence from other diseases. Osteoarthr Cartil 2009, 17(3):281-283.