Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
The Royal Free Hospital, London, UK.
Osteoarthritis Cartilage. 2022 Oct;30(10):1287-1327. doi: 10.1016/j.joca.2022.08.002. Epub 2022 Aug 11.
We conducted a systematic review in order to understand the relationship between imaging-visualised meniscus pathologies, hyaline cartilage, joint replacement and pain in knee osteoarthritis (OA).
A search of the Medline, Excerpta Medica database (EMBASE) and Cochrane library databases was performed for original publications reporting association between imaging-detected meniscal pathology (extrusion or tear/damage) and longitudinal and cross-sectional assessments of hyaline articular cartilage loss [assessed on magnetic resonance imaging (MRI)], incident joint replacement and pain (longitudinal and cross-sectional) in knee OA. Each association was qualitatively characterised by a synthesis of data from each analysis, based upon study design and quality scoring (including risk of bias assessment and adequacy of covariate adjustment using Cochrane recommended methodology).
In total 4,878 abstracts were screened and 82 publications were included (comprising 72 longitudinal analyses and 49 cross-sectional). Using high quality, well-adjusted data, meniscal extrusion and meniscal tear/damage were associated with longitudinal progression of cartilage loss, cross-sectional cartilage loss severity and joint replacement, independently of age, sex and body mass index (BMI). Medial and lateral meniscal tears were associated with cartilage loss when they occurred in the body and posterior horns, but not the anterior horns. There was a lack of high quality, well-adjusted meniscal pathology and pain publications and no clear independent association between meniscal extrusion or tear/damage with pain severity, progression in pain or incident frequent knee symptoms.
Meniscal features have strong associations with cartilage loss and joint replacement in knee OA, but weak associations with knee pain. Systematic review PROSPERO registration number: CRD 42020210910.
为了了解膝关节骨关节炎（OA）中影像学可见的半月板病变、透明软骨、关节置换和疼痛之间的关系，我们进行了一项系统评价。
对 Medline、Excerpta Medica 数据库（EMBASE）和 Cochrane 图书馆数据库进行了原始出版物检索，这些出版物报告了影像学检测到的半月板病变（挤出或撕裂/损伤）与透明关节软骨丢失（通过磁共振成像 [MRI] 评估）、膝关节 OA 中关节置换和疼痛（纵向和横向）的纵向和横向评估之间的关系。每个关联均根据研究设计和质量评分（包括使用 Cochrane 推荐方法进行偏倚风险评估和协变量调整的充分性），通过对每项分析的数据进行综合定性描述。
共筛选了 4878 篇摘要，纳入了 82 篇文献（包括 72 项纵向分析和 49 项横断面分析）。使用高质量、充分调整的数据，半月板挤出和半月板撕裂/损伤与软骨丢失的纵向进展、横断面软骨丢失严重程度和关节置换独立相关，与年龄、性别和体重指数（BMI）无关。内侧和外侧半月板撕裂发生在体部和后角时与软骨丢失相关，但在前角则不相关。缺乏高质量、充分调整的半月板病变和疼痛出版物，半月板挤出或撕裂/损伤与疼痛严重程度、疼痛进展或频繁膝关节症状的发生之间没有明确的独立关联。
半月板特征与膝关节 OA 中的软骨丢失和关节置换有很强的关联，但与膝关节疼痛的关联较弱。系统评价 PROSPERO 注册号：CRD42020210910。
