Zeng Mengjie, Cicuttini Flavia M, Wluka Anita E, Jones Graeme, Hill Catherine L, Ding Changhai, Wang Yuanyuan
School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
Skeletal Radiol. 2025 Feb;54(2):219-228. doi: 10.1007/s00256-024-04731-2. Epub 2024 Jun 15.
To examine the association between medial meniscal extrusion and structural progression in adults with symptomatic knee osteoarthritis (OA).
This prospective cohort study examined 176 participants with symptomatic knee OA recruited into a randomised controlled trial. The participants underwent magnetic resonance imaging (MRI) of the study knee at baseline and approximately 2 years later. Meniscal extrusion, tibial cartilage volume, and tibiofemoral bone marrow lesions (BMLs) were measured from MRI using validated methods.
Participants with medial meniscal extrusion ≥ 3 mm had a higher prevalence of lateral tibiofemoral BMLs at baseline (OR = 2.21, 95% CI 1.06-4.61, p = 0.035), and those with medial meniscal extrusion 2-3 mm had a higher likelihood of lateral BML worsening over 2 years (OR = 3.76, 95% CI 1.35-10.52, p = 0.011), compared with those with medial meniscal extrusion < 2 mm. Participants with stable medial meniscal extrusion had a lower likelihood of lateral BML worsening compared with those with regression of medial meniscal extrusion over 2 years (OR = 0.20, 95% CI 0.07-0.56, p = 0.002). There were no associations between medial meniscal extrusion and tibial cartilage volume or medial tibiofemoral BMLs.
Our study showed associations between medial meniscal extrusion and baseline prevalence and worsening over 2 years of lateral tibiofemoral BMLs in people with symptomatic knee OA. Although the reasons for the lack of associations in the medial compartment are not clear, our results suggest a role of medial meniscal extrusion in predicting structural progression in lateral knee OA and that meniscal extrusion might be a potential target in the management of knee OA.
探讨有症状的膝关节骨关节炎（OA）成人患者内侧半月板挤出与结构进展之间的关联。
这项前瞻性队列研究对176名有症状的膝关节OA参与者进行了检查，这些参与者被纳入一项随机对照试验。参与者在基线时以及大约2年后对研究膝关节进行了磁共振成像（MRI）检查。使用经过验证的方法从MRI测量半月板挤出、胫骨软骨体积和胫股骨髓损伤（BMLs）。
内侧半月板挤出≥3mm的参与者在基线时外侧胫股BMLs的患病率较高（OR = 2.21，95%CI 1.06 - 4.61，p = 0.035），与内侧半月板挤出<2mm的参与者相比，内侧半月板挤出2 - 3mm的参与者在2年内外侧BMLs恶化的可能性更高（OR = 3.76，95%CI 1.35 - 10.52，p = 0.011）。与内侧半月板挤出在2年内出现退缩的参与者相比，内侧半月板挤出稳定的参与者外侧BMLs恶化的可能性较低（OR = 0.20，95%CI 0.07 - 0.56，p = 0.002）。内侧半月板挤出与胫骨软骨体积或内侧胫股BMLs之间没有关联。
我们的研究表明，有症状的膝关节OA患者中，内侧半月板挤出与外侧胫股BMLs的基线患病率以及2年内的恶化情况之间存在关联。尽管内侧间室缺乏关联的原因尚不清楚，但我们的结果表明内侧半月板挤出在预测外侧膝关节OA的结构进展中具有作用，并且半月板挤出可能是膝关节OA管理中的一个潜在靶点。
