Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Faculty of Nursing And Medical Care, Keio University, Fujisawa, Kanagawa, Japan.
Eur Radiol. 2020 Jul;30(7):3996-4004. doi: 10.1007/s00330-020-06749-1. Epub 2020 Mar 6.
To clarify the relationship between the baseline value of medial meniscus extrusion (MME) and the radiographic change of knee osteoarthritis (KOA) through a 5-year follow-up.
Overall, 472 participants and 944 knees were eligible. MME (mm) was measured at the baseline, and KOA was radiographically evaluated at both baseline and 5-year follow-up by Kellgren-Lawrence grade (KLG). Radiographic KOA (ROA) was defined as the knee showing KLG ≥ 2. Incident ROA (iROA) was defined if the baseline KLG of 0-1 increased to KLG ≥ 2 in 5 years. Progressive ROA (pROA) was defined if the baseline KLG of 2-3 worsened to a higher grade in 5 years. Receiver operating characteristic (ROC) curve and generalized estimating equations were used for analysis.
Of 574 non-ROA knees at the baseline, 43 knees (7.5%) developed iROA; of 370 ROA knees, 47 knees (12.7%) developed pROA. Based on the ROC curves, 4 mm was the optimal cutoff to detect the risk of iROA (area under curve [AUC] 0.639 [right knee]; AUC 0.641 [left knee]) and that of pROA (AUC 0.750 [right knee]; AUC 0.863 [left knee]). Multiple regression analysis showed that the 4-mm cutoff of MME was significantly associated with both the prevalence of iROA (regression coefficient [B] 1.909; p ≤ 0.001; adjusted odds ratio [aOR] 6.746) and that of pROA (B 1.791; p ≤ 0.001; aOR 5.993).
On ultrasonography, the participants with more extruded medial meniscus showed a higher prevalence of both iROA and pROA. Ultrasonography could identify patients who had a risk of developing KOA.
• Through a 5-year follow-up, the current cohort study was conducted to clarify the relationship between the baseline value of medial meniscus extrusion (MME) and the radiographic change of knee osteoarthritis (KOA). • More extruded medial meniscus evaluated by ultrasonography was associated with the development of radiographic KOA. • Ultrasonography could identify the patients who had a risk of developing KOA, and the 4-mm cutoff of MME was optimal to detect this risk.
通过 5 年随访，明确内侧半月板外突（MME）基线值与膝关节骨关节炎（KOA）放射学变化之间的关系。
共纳入 472 名参与者和 944 个膝关节。在基线时测量 MME（mm），并在基线和 5 年随访时通过 Kellgren-Lawrence 分级（KLG）对 KOA 进行放射学评估。放射学 KOA（ROA）定义为 KLG≥2 的膝关节。如果基线时 KLG 为 0-1 的膝关节在 5 年内增加到 KLG≥2，则定义为新发 ROA（iROA）。如果基线时 KLG 为 2-3 的膝关节在 5 年内恶化到更高的分级，则定义为进展性 ROA（pROA）。采用受试者工作特征（ROC）曲线和广义估计方程进行分析。
在基线时无 ROA 的 574 个膝关节中，有 43 个（7.5%）发展为 iROA；在 370 个 ROA 膝关节中，有 47 个（12.7%）发展为 pROA。根据 ROC 曲线，4mm 是检测 iROA 风险的最佳截断值（右侧膝关节 AUC 0.639；左侧膝关节 AUC 0.641）和 pROA（右侧膝关节 AUC 0.750；左侧膝关节 AUC 0.863）。多因素回归分析显示，MME 的 4mm 截断值与 iROA 的患病率（回归系数[B]1.909；p≤0.001；调整后比值比[aOR]6.746）和 pROA 的患病率（B 1.791；p≤0.001；aOR 5.993）显著相关。
在超声检查中，内侧半月板外突程度较大的患者更易发生新发 ROA 和进展性 ROA。超声检查可以识别出有发生 KOA 风险的患者。
通过 5 年随访，本队列研究旨在明确内侧半月板外突（MME）基线值与膝关节骨关节炎（KOA）放射学变化之间的关系。
超声评估的内侧半月板外突程度越大，与放射学 KOA 的发生相关。
超声检查可以识别出有发生 KOA 风险的患者，MME 的 4mm 截断值是检测这种风险的最佳选择。
