Medial meniscus extrusion increases with age and BMI and is depending on different loading conditions

Abstract Purpose: To elucidate the association between medial meniscus extrusion measured on ultrasonography (MMEUS) and the prevalence of medial meniscus posterior root tear detected on magnetic resonance imaging (MMPRTMRI). Methods: We recruited 127 patients (135 knees) in this cross-sectional study. All participants had medial knee pain without a knee trauma or surgery history. Knee osteoarthritis (KOA) severity was evaluated using Kellgren-Lawrence grade (KLG) scores. Patients with KLG scores 0-1 and ≥2 were classified in non-radiographic (non-ROA) and radiographic KOA (ROA) groups, respectively. MMEUS was measured with patients in the supine position. Based on T2*-weighted images, MMPRTMRI was defined as the presence of “Ghost meniscus sign” and “Creft/truncation sign”, indicating an abnormal high signal intensity of a disrupted posterior root. MMEUS was compared between MMPRT+ and MMPRT– patients using a non-paired t-test. Receiver operating characteristic (ROC) curves were used to determine the optimal cut-off MMEUS to predict MMPRT+.Results: The prevalence of MMPRT+ was 31.3% (25/80 knees) and 29.1% (16/55 knees) in the non-ROA and ROA groups. The MMEUS of MMPRT+ patients were significantly greater than that of MMPRT– patients in both the non-ROA (5.9±1.4 mm vs. 4.4±1.0 mm, P<0.001) and ROA (7.8±1.3 mm vs. 6.3±1.3 mm, P<0.001) groups. ROC curves demonstrated that 5-mm and 7-mm MMEUS were the optimal cut-off values in non-ROA (adjusted odds ratio: 6.280; area under the curve [AUC]: 0.809; P<0.001) and ROA (adjusted odds ratio: 15.003; AUC: 0.797; P=0.001) groups.Conclusions: In early non-radiographic KOA stages, a greater MMEUS was associated with a higher MMPRTMRI prevalence.Level of evidence: III, Cross-sectional cohort study

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Medial meniscus extrusion is associated with the gait speed among the MRI-detected pathophysiologies of the knee joint in patients with knee osteoarthritis

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2019.02.209 ◽

2019 ◽

Vol 27 ◽

pp. S143

Author(s):

H. Arita ◽

M. Ishijima ◽

H. Kaneko ◽

M. Ishibashi ◽

M. Kinoshita ◽

...

Keyword(s):

Knee Joint ◽

Knee Osteoarthritis ◽

Gait Speed ◽

Medial Meniscus ◽

Medial Meniscus Extrusion ◽

Meniscus Extrusion

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A repair technique using two simple stitches reduces the short-term postoperative medial meniscus extrusion after pullout repair for medial meniscus posterior root tear

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-020-02647-w ◽

2020 ◽

Vol 30 (5) ◽

pp. 901-908 ◽

Cited By ~ 4

Author(s):

Takaaki Hiranaka ◽

Takayuki Furumatsu ◽

Shin Masuda ◽

Yoshiki Okazaki ◽

Yuki Okazaki ◽

...

Keyword(s):

Medial Meniscus ◽

Posterior Root ◽

Root Tear ◽

Short Term ◽

Posterior Root Tear ◽

Repair Technique ◽

Pullout Repair ◽

Medial Meniscus Extrusion ◽

Meniscus Extrusion

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Preoperative Meniscal Extrusion Predicts Unsatisfactory Clinical Outcomes and Progression of Osteoarthritis after Isolated Partial Medial Meniscectomy: A 5-Year Follow-Up Study

The Journal of Knee Surgery ◽

10.1055/s-0040-1715109 ◽

2020 ◽

Author(s):

João V. Novaretti ◽

Diego C. Astur ◽

Elton L.B. Cavalcante ◽

Camila C. Kaleka ◽

Joicemar T. Amaro ◽

...

Keyword(s):

Clinical Outcomes ◽

Medial Meniscus ◽

International Knee Documentation Committee ◽

Meniscal Extrusion ◽

Optimal Cutoff ◽

Medial Meniscectomy ◽

The Mean ◽

Medial Meniscus Extrusion ◽

Meniscus Extrusion

AbstractThe objective of this study was to examine the association between preoperative meniscal extrusion of patients undergoing partial medial meniscectomy with clinical outcomes and progression of osteoarthritis and to determine the extent of meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis. Ninety-five patients who underwent partial medial meniscectomy with a minimum follow-up of 5 years were retrospectively reviewed. Preoperative meniscal extrusion was evaluated with magnetic resonance imaging. Patients were assessed preoperatively and postoperatively with Lysholm and International Knee Documentation Committee (IKDC) subjective scores for clinical outcomes and with IKDC radiographic scale for osteoarthritis. An ANOVA (Analysis of Variance) was used to analyze the variations in meniscal extrusion and the clinical and radiological outcomes. A regression analysis was performed to identify factors that affect preoperative medial meniscus extrusion and that influence results after partial meniscectomy. An optimal cutoff value for meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis was established. Significance was set at p < 0.05. The mean ± SD preoperative and postoperative Lysholm scores were 59.6 ± 15.5 versus 83.8 ± 13.1 (p < 0.001) and the mean preoperative and postoperative IKDC subjective scores were 59.4 ± 16.8 versus 82.0 ± 15.8 (p < 0.001). Meniscal extrusion greater than 2.2 mm (sensitivity, 84%; specificity, 81%) and 2.8 mm (sensitivity, 73%; specificity, 85%) was associated with unsatisfactory (poor/fair) Lysholm and IKDC subjective scores, respectively. The progression of osteoarthritis, characterized as a change of at least one category on the IKDC radiographic scale, occurred when meniscal extrusion was greater than 2.2 mm (sensitivity, 63%; specificity, 75%). Patients with higher body mass index (BMI) had significantly greater meniscal extrusion that patients with normal BMI (p < 0.001). The medial meniscus was more extruded in patients with horizontal and root tears. In conclusion, patients with preoperative meniscal extrusion of 2.2 mm or greater had unsatisfactory clinical outcomes and progression of osteoarthritis after partial medial meniscectomy at a minimum of 5 years follow-up. Higher BMI and horizontal and root tears were associated with greater preoperative meniscal extrusion.

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