Difference in the joint space of the medial knee compartment between full extension and Rosenberg weight-bearing radiographs

Abstract Objectives Radiographs are the most widespread imaging tool for diagnosing osteoarthritis (OA) of the knee. Our purpose was to determine which of the two factors, medial meniscus extrusion (MME) or cartilage thickness, had a greater effect on the difference in the minimum joint space width (mJSW) at the medial compartment between the extension anteroposterior view (extension view) and the 45° flexion posteroanterior view (Rosenberg view). Methods The subjects were 546 participants (more than 50 females and 50 males in their 30 s, 40 s, 50 s, 60 s, and 70 s) in the Kanagawa Knee Study. The mJSW at the medial compartment was measured from both the extension and the Rosenberg views, and the “mJSW difference” was defined as the mJSW in the Rosenberg view subtracted from the mJSW in the extension view. The cartilage region was automatically extracted from MRI data and constructed in three dimensions. The medial region of the femorotibial joint cartilage was divided into 18 subregions, and the cartilage thickness in each subregion was determined. The MME was also measured from MRI data. Results The mJSW difference and cartilage thickness were significantly correlated at 4 subregions, with 0.248 as the highest absolute value of the correlation coefficient. The mJSW difference and MME were also significantly correlated, with a significantly higher correlation coefficient (0.547) than for the mJSW difference and cartilage thickness. Conclusions The MME had a greater effect than cartilage thickness on the difference between the mJSW at the medial compartment in the extension view and in the Rosenberg view. Key Points • The difference in the width at the medial compartment of the knee between the extension and the flexion radiographic views was more affected by medial meniscus extrusion than by cartilage thickness.

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Relationship between medial meniscus extrusion and cartilage measurements in the knee by fully automatic three-dimensional MRI analysis

10.21203/rs.3.rs-43802/v3 ◽

2020 ◽

Author(s):

Hayato Aoki ◽

Nobutake Ozeki ◽

Hisako Katano ◽

Akinobu Hyodo ◽

Yugo Miura ◽

...

Keyword(s):

Medial Meniscus ◽

Three Dimensional ◽

Study Data ◽

Cartilage Thickness ◽

Similarity Coefficients ◽

Tibial Cartilage ◽

The Relationship ◽

Medial Meniscus Extrusion ◽

Meniscus Extrusion ◽

And Cartilage

Abstract Background: We developed a fully automatic three-dimensional knee MRI analysis software that can quantify meniscus extrusion and cartilage measurements, including the projected cartilage area ratio (PCAR), which represents the ratio of the subject’s actual cartilage area to their ideal cartilage area. We also collected 3D MRI knee data from 561 volunteers (aged 30–79 years) from the “Kanagawa Knee Study.” Our purposes were to verify the accuracy of the software for automatic cartilage and meniscus segmentation using knee MRI and to examine the relationship between medial meniscus extrusion measurements and cartilage measurements from Kanagawa Knee Study data. Methods: We constructed a neural network for the software by randomly choosing 10 healthy volunteers and 103 patients with knee pain. We validated the algorithm by randomly selecting 108 of these 113 subjects for training, and determined Dice similarity coefficients from five other subjects. We constructed a neural network using all data (113 subjects) for training. Cartilage thickness, cartilage volume, and PCAR in the medial femoral, lateral femoral, medial tibial, and lateral tibial regions were quantified by using the trained software on Kanagawa Knee Study data and their relationship with subject height was investigated. We also quantified the medial meniscus coverage ratio (MMCR), defined as the ratio of the overlapping area between the medial meniscus area and the medial tibial cartilage area to the medial tibial cartilage area. Finally, we examined the relationship between MMCR and PCAR at middle central medial tibial (mcMT) subregion located in the center of nine subregions in the medial tibial cartilage. Results: Dice similarity coefficients for cartilage and meniscus were both approximately 0.9. The femoral and tibial cartilage thickness and volume at each region correlated with height, but PCAR did not correlate with height in most settings. PCAR at the mcMT was significantly correlated with MMCR. Conclusions: Our software showed high segmentation accuracy for the knee cartilage and meniscus. PCAR was more useful than cartilage thickness or volume since it was less affected by height. A relationship was observed between the medial tibial cartilage measurements and the medial meniscus extrusion measurement in our cross-sectional study.

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Relationship between medial meniscus extrusion and cartilage measurements in the knee by fully automatic three-dimensional MRI analysis

10.21203/rs.3.rs-43802/v2 ◽

2020 ◽

Author(s):

Hayato Aoki ◽

Nobutake Ozeki ◽

Hisako Katano ◽

Akinobu Hyodo ◽

Yugo Miura ◽

...

Keyword(s):

Medial Meniscus ◽

Three Dimensional ◽

Cartilage Thickness ◽

Similarity Coefficients ◽

Tibial Cartilage ◽

Fully Automatic ◽

The Relationship ◽

Medial Meniscus Extrusion ◽

Meniscus Extrusion ◽

And Cartilage

Abstract BackgroundWe developed a fully automatic three-dimensional knee MRI analysis software that can quantify meniscus extrusion and cartilage measurements, including the projected cartilage area ratio (PCAR), which represents the ratio of the subject’s actual cartilage area to their ideal cartilage area. We also collected 3D MRI knee data from 561 volunteers (aged 30–79 years) from the “Kanagawa Knee Study.” Our purposes were to verify the accuracy of the software for automatic cartilage and meniscus segmentation using knee MRI and to examine the relationship between medial meniscus extrusion measurements and cartilage measurements from Kanagawa Knee Study data.MethodsWe constructed a neural network for the software by randomly choosing 10 healthy volunteers and 103 patients with knee pain. We validated the algorithm by randomly selecting 108 of these 113 subjects for training, and determined Dice similarity coefficients from five other subjects. We constructed a neural network using all data (113 subjects) for training. Cartilage thickness, cartilage volume, and PCAR in the medial femoral, lateral femoral, medial tibial, and lateral tibial regions were quantified by using the trained software on Kanagawa Knee Study data and their relationship with subject height was investigated. We also quantified the medial meniscus coverage ratio (MMCR), defined as the ratio of the overlapping area between the medial meniscus area and the medial tibial cartilage area to the medial tibial cartilage area. Finally, we examined the relationship between MMCR and PCAR at middle central medial tibial (mcMT) subregion located in the center of nine subregions in the medial tibial cartilage.ResultsDice similarity coefficients for cartilage and meniscus were both approximately 0.9. The femoral and tibial cartilage thickness and volume at each region correlated with height, but PCAR did not correlate with height in most settings. PCAR at the mcMT was significantly correlated with MMCR.ConclusionsOur software showed high segmentation accuracy for the knee cartilage and meniscus. PCAR was more useful than cartilage thickness or volume since it was less affected by height. A relationship was observed between the medial tibial cartilage measurements and the medial meniscus extrusion measurement in our cross-sectional study.Trial registration: UMIN, UMIN000032826; 1 September 2018,https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037299

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Relationship between medial meniscus extrusion and cartilage measurements in the knee by fully automatic three-dimensional MRI analysis

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03768-3 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Hayato Aoki ◽

Nobutake Ozeki ◽

Hisako Katano ◽

Akinobu Hyodo ◽

Yugo Miura ◽

...

Keyword(s):

Medial Meniscus ◽

Three Dimensional ◽

Study Data ◽

Cartilage Thickness ◽

Similarity Coefficients ◽

Tibial Cartilage ◽

The Relationship ◽

Medial Meniscus Extrusion ◽

Meniscus Extrusion ◽

And Cartilage

Abstract Background We developed a fully automatic three-dimensional knee MRI analysis software that can quantify meniscus extrusion and cartilage measurements, including the projected cartilage area ratio (PCAR), which represents the ratio of the subject’s actual cartilage area to their ideal cartilage area. We also collected 3D MRI knee data from 561 volunteers (aged 30–79 years) from the “Kanagawa Knee Study.” Our purposes were to verify the accuracy of the software for automatic cartilage and meniscus segmentation using knee MRI and to examine the relationship between medial meniscus extrusion measurements and cartilage measurements from Kanagawa Knee Study data. Methods We constructed a neural network for the software by randomly choosing 10 healthy volunteers and 103 patients with knee pain. We validated the algorithm by randomly selecting 108 of these 113 subjects for training, and determined Dice similarity coefficients from five other subjects. We constructed a neural network using all data (113 subjects) for training. Cartilage thickness, cartilage volume, and PCAR in the medial femoral, lateral femoral, medial tibial, and lateral tibial regions were quantified by using the trained software on Kanagawa Knee Study data and their relationship with subject height was investigated. We also quantified the medial meniscus coverage ratio (MMCR), defined as the ratio of the overlapping area between the medial meniscus area and the medial tibial cartilage area to the medial tibial cartilage area. Finally, we examined the relationship between MMCR and PCAR at middle central medial tibial (mcMT) subregion located in the center of nine subregions in the medial tibial cartilage. Results Dice similarity coefficients for cartilage and meniscus were both approximately 0.9. The femoral and tibial cartilage thickness and volume at each region correlated with height, but PCAR did not correlate with height in most settings. PCAR at the mcMT was significantly correlated with MMCR. Conclusions Our software showed high segmentation accuracy for the knee cartilage and meniscus. PCAR was more useful than cartilage thickness or volume since it was less affected by height. Relations ips were observed between the medial tibial cartilage measurements and the medial meniscus extrusion measurements in our cross-sectional study. Trial registration UMIN, UMIN000032826; 1 September 2018,

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Is it possible to use stress radiographs as a tool to diagnose medial meniscus posterior root tears?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117s00073 ◽

2017 ◽

Vol 5 (2_suppl2) ◽

pp. 2325967117S0007

Author(s):

Ali Engin Daştan ◽

Elcil Kaya Biçer ◽

Hüseyin Kaya ◽

Emin Taşkıran

Keyword(s):

Medial Meniscus ◽

Weight Bearing ◽

Joint Space Width ◽

Joint Space ◽

X Rays ◽

Meniscal Extrusion ◽

Valgus Stress ◽

Varus Stress ◽

The Difference ◽

Space Width

Aim: Medial meniscus posterior root tear (MMPRT) causes meniscal extrusion, loss of meniscus function, arthritic changes. Clinical history, physical examination and magnetic resonance imaging (MRI) findings are useful for the diagnosis of MMPRT. The aim of this study is to evaluate the utility of stress X-rays in the diagnosis of MMPRT. Methods: Twenty patients who had undergone high tibial osteotomy between March 2015 and May 2016 and whose preoperative bilateral varus and valgus stress x-rays (Telos device) along with weight bearing x-rays were available were included. These patients were grouped into two according to integrity of posterior roots of their medial menisci; there were ten patients both in the study and control groups. Lateral joint space width (LJW) on varus stress x-rays, medial joint space width (MJW) on valgus stress x-rays as well as LJW and MJW on weight bearing x-rays were measured bilaterally. Intragroup comparisons of joint space widths between index and opposite knees were performed. Differences of MJW and LJW between index and opposite knees were calculated. Differences of joint space widths between stress x-rays and weight bearing x-rays were also calculated. The changes in joint space widths between the two groups were compared. Statistical analyses were performed utilizing SPSS 18.0. Significance level was set at 0.05. Results: In MMPRT group, opening of LJ space of index knees under varus stress was greater than that of opposite knees (Index: (mean±SD) 10,27±1,17 mm, opposite: 8,61±1,37 mm; p<0,0001). In the control group the difference was not significant (Index: 9,29±2,55 mm, opposite: 9,68±1,44 mm; p=0,566). The difference in the opening of LJW (under varus stress) between index and opposite knees was significantly greater in the study group (p=0,013). The difference between LJW under weight-bearing and varus stress conditions was significantly greater in the study group. (Study: 3,64±0.217 mm, control:2,28±0,182 mm, p=0.018). Conclusions: The findings of this study showed that in patients who had MMPRTs, an increased opening in the LJW was observed under varus stress conditions. This may be relevant with the fact that when varus stress is applied, meniscal extrusion is increased in case of a MMPRT. Stress x-rays could be a useful tool in the diagnosis of MMPRTs. Further studies are needed to determine the sensitivity and specificity of this diagnostic tool.

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