Kahat David H, Nouraee Cyrus M, Smith Jesse S, Santiago Cassiano C, Floyd Edward R, Zbyn Stefan, Abbasguliyev Hasan, Kajabi Abdul Wahed, Ellermann Jutta M
Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA.
University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Orthop J Sports Med. 2024 Aug 9;12(8):23259671241248457. doi: 10.1177/23259671241248457. eCollection 2024 Aug.
Medial meniscal extrusion (MME) has been associated with knee osteoarthritis (OA). However, there is no standardized method to measure MME.
PURPOSE/HYPOTHESIS: The purpose of this study was to investigate the relationship between MME and outcome measures related to knee OA and discuss different magnetic resonance imaging (MRI) methods of measuring MME. It was hypothesized that MME would be associated with outcome measures of OA and that the distance extruded over the tibial plateau would be the most common MRI method to measure MME.
Systematic review; Level of evidence, 3.
The MEDLINE, Embase, Cochrane Library, Scopus, Web of Science Core Collection, Global Index Medicus, and ClinicalTrials.gov databases were systematically searched. The inclusion criteria were studies that (1) measured MME on nonoperated knees using MRI; (2) evaluated knee OA with at least 1 knee OA grading scale, outcome measure, or direct characterization of cartilage or bone; (3) statistically evaluated the association between MME and knee OA outcome measure; (4) were randomized controlled trials, nonrandomized controlled trials, cohort studies, or case series; and (5) reported original results.
A total of 19 studies were included, of which 14 reported MME as the distance extruded over the tibial plateau, 7 reported MME as the volume extruded over the tibial plateau, and 1 reported MME as the percentage of the tibial plateau covered by the meniscus. All studies reported that MME was significantly associated with at least 1 OA outcome measure-including increased Kellgren-Lawrence grade, osteophytes, cartilage damage, varus alignment, knee pain, bone marrow lesions, and progression to arthroplasty. Eight studies found that MME was associated with worse OA outcomes over time (range, 2-10 years).
All 19 reviewed studies reported that MME was associated with at least 1 knee OA outcome measure reflective of worsening arthritis, suggesting a strong association between OA and MME. Future research is needed to investigate this relationship and standardize the methods of measuring MME.
内侧半月板挤出（MME）与膝关节骨关节炎（OA）有关。然而，目前尚无测量MME的标准化方法。
目的/假设：本研究的目的是探讨MME与膝关节OA相关结局指标之间的关系，并讨论测量MME的不同磁共振成像（MRI）方法。研究假设为，MME将与OA的结局指标相关，且在胫骨平台上挤出的距离将是测量MME最常用的MRI方法。
系统评价；证据等级，3级。
系统检索MEDLINE、Embase、Cochrane图书馆、Scopus、科学网核心合集、全球医学索引和ClinicalTrials.gov数据库。纳入标准为符合以下条件的研究：（1）使用MRI测量非手术膝关节的MME；（2）至少使用1种膝关节OA分级量表、结局指标或对软骨或骨进行直接特征描述来评估膝关节OA；（3）对MME与膝关节OA结局指标之间的关联进行统计学评估；（4）为随机对照试验、非随机对照试验、队列研究或病例系列；（5）报告原始结果。
共纳入19项研究，其中14项将MME报告为在胫骨平台上挤出的距离，7项将MME报告为在胫骨平台上挤出的体积，1项将MME报告为半月板覆盖胫骨平台的百分比。所有研究均报告MME与至少1项OA结局指标显著相关，包括Kellgren-Lawrence分级增加、骨赘、软骨损伤、内翻畸形、膝关节疼痛、骨髓损伤以及进展为关节置换术。8项研究发现，随着时间推移（范围为2至10年），MME与更差的OA结局相关。
所有19项纳入综述的研究均报告MME与至少1项反映关节炎恶化的膝关节OA结局指标相关，提示OA与MME之间存在密切关联。未来需要进一步研究来探讨这种关系并规范MME的测量方法。
