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Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging

¹ Centre hospitalier de l’Université de Montréal (CHUM), Department of Radiology, Notre-Dame Hospital, University of Montreal, Montreal, Québec, Canada
² Osteoarthritis Research Unit, CHUM, Department of Medicine, Notre-Dame Hospital, University of Montreal
³ ArthroVision, Montréal
⁴ School of Medicine, Department of Health Research and Policy, Stanford University, Stanford, California, USA
⁵ CHUM, Department of Medicine, Notre-Dame Hospital, University of Montreal
⁶ UCLA Los Angeles, California, USA
⁷ University of Maryland, Baltimore, Maryland, USA
⁸ Procter & Gamble Pharmaceuticals, Mason, Ohio, USA

Correspondence to:
Correspondence to:
Dr Jean-Pierre Raynauld
Osteoarthritis Research Unit, 1560 Sherbrooke St East, Montreal, Quebec, Canada H2L 4MI; jp.raynauld{at}videotron.ca

Background: The relation between knee meniscal structural damage and cartilage degradation is plausible but not yet clearly proven.

Objectives: To quantitate the cartilage volume changes in knee osteoarthritis using magnetic resonance imaging (MRI), and determine whether meniscal alteration predicts cartilage volume loss over time.

Methods: 32 patients meeting ACR criteria for symptomatic knee osteoarthritis were studied. MRI knee acquisitions were done every six months for two years. The cartilage volumes of different knee regions were measured. Three indices of structural change in the medial and lateral menisci were evaluated—degeneration, tear, and extrusion—using a semiquantitative scale.

Results: 24 patients (75%) had mild to moderate or severe meniscal damage (tear or extrusion) at baseline. A highly significant difference in global cartilage volume loss was observed between severe medial meniscal tear and absence of tear (mean (SD), –10.1 (2.1)% v –5.1 (2.4)%, p = 0.002). An even greater difference was found between the medial meniscal changes and medial compartment cartilage volume loss (–14.3 (3.0)% in the presence of severe tear v –6.3 (2.7)% in the absence of tear; p<0.0001). Similarly, a major difference was found between the presence of a medial meniscal extrusion and loss of medial compartment cartilage volume (–15.4 (4.1)% in the presence of extrusion v –4.5 (1.7)% with no extrusion; p<0.001).

Conclusions: Meniscal tear and extrusion appear to be associated with progression of symptomatic knee osteoarthritis.

Abbreviations: ACR, American College of Rheumatology; FISP, fast inflow with steady state precession; JSW, joint space width

Keywords: Knee; cartilage; osteoarthritis; quantitative MRI

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