Fellow, Primary Care Sports Medicine, Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
Physician, Department of Physical Medicine and Rehabilitation, Avera Medical Group, Sioux Falls, SD, USA.
PM R. 2021 May;13(5):470-478. doi: 10.1002/pmrj.12450. Epub 2020 Oct 19.
Medial meniscal extrusion (MME) has been correlated with medial meniscal injury and progression of medial knee osteoarthritis (OA).
To examine the difference in MME between non-weight-bearing (supine) and weight-bearing (standing) positions in patients with and without medial knee OA. Determine the correlation between body mass index (BMI), Kellgren-Lawrence (KL) grade, Knee Osteoarthritis Outcome Score (KOOS), and MME.
Prospective.
Tertiary institution PM&R Department.
Forty five participants (29 female, 16 male), 24 with healthy knees and 21 with OA.
A single physician sonographer measured supine and standing MME with ultrasound (US) on each participant. The physician was blinded to all measurements. BMI was recorded on all participants. KL grades and KOOS questionnaires were obtained for the OA group.
MME in supine and standing positions, change in MME from supine to standing, BMI, KL grade, and KOOS subscale scores.
MME increased .52 mm from supine to standing (P < .001). MME was greater in the OA group in both the supine (P = .002) and standing (P < .001) positions. Increasing BMI was moderately correlated with increasing MME (supine P = .001, standing <.001). Increasing age was correlated with increasing MME (supine P = .012, standing P = .002). Increasing KL grade (from 1 to 4) was correlated with increasing MME (supine P = .015, standing = .006). There was a small-to-moderate correlation between KOOS activities of daily living (ADL) subscale score and change in MME from supine to standing (P = .035). The change in MME from supine to standing positions had a small-to-moderate correlation (P = .035) with KOOS ADL subscale score alone but did not correlate with any of the other KOOS subscale scores or KOOS total scores. Receiver operating characteristic curve analysis suggested a standing MME value of 4.2 mm provides a positive likelihood ratio of 6.02 for knee OA.
MME is greater in those with OA and with weight-bearing. MME correlates with BMI, age, KL grade, and the KOOS ADL subscale score. Finally, standing MME of 4.2 mm yielded a higher positive likelihood ratio to differentiate between healthy knees and those with medial compartment OA than the previously reported value of 3.0 mm.
内侧半月板挤压（MME）与内侧半月板损伤和内侧膝关节骨关节炎（OA）的进展有关。
检查有和没有内侧膝关节 OA 的患者在非负重（仰卧）和负重（站立）位置之间 MME 的差异。确定体重指数（BMI）、Kellgren-Lawrence（KL）分级、膝关节骨关节炎结果评分（KOOS）和 MME 之间的相关性。
前瞻性。
三级机构 PM&R 系。
45 名参与者（29 名女性，16 名男性），24 名健康膝关节和 21 名 OA。
一名医生超声医师在每个参与者的仰卧位和站立位测量 MME。医生对所有测量均不知情。所有参与者均记录 BMI。对 OA 组进行 KL 分级和 KOOS 问卷调查。
仰卧位和站立位的 MME、仰卧位到站立位 MME 的变化、BMI、KL 分级和 KOOS 亚量表评分。
MME 从仰卧位到站立位增加了 0.52mm（P<.001）。OA 组在仰卧位（P=.002）和站立位（P<.001）的 MME 均更大。BMI 增加与 MME 增加呈中度相关（仰卧位 P=.001，站立位<.001）。年龄增加与 MME 增加相关（仰卧位 P=.012，站立位 P=.002）。KL 分级（从 1 级到 4 级）增加与 MME 增加相关（仰卧位 P=.015，站立位 P=.006）。KOOS 日常生活活动（ADL）亚量表评分与仰卧位到站立位 MME 的变化呈小到中度相关（P=.035）。仰卧位到站立位 MME 的变化与 KOOS ADL 亚量表评分本身呈小到中度相关（P=.035），但与 KOOS 的任何其他亚量表评分或 KOOS 总分均不相关。受试者工作特征曲线分析表明，站立 MME 值为 4.2mm 时，OA 的阳性似然比为 6.02。
OA 患者和负重患者的 MME 更大。MME 与 BMI、年龄、KL 分级和 KOOS ADL 亚量表评分相关。最后，站立 MME 为 4.2mm 时，区分健康膝关节和内侧间室 OA 的阳性似然比高于之前报道的 3.0mm 值。
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