, Volume 22, Issue 1, pp 211-220

Relationship of 3D meniscal morphology and position with knee pain in subjects with knee osteoarthritis: a pilot study

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Abstract

Objectives

To explore whether quantitative, three-dimensional measurements of meniscal position and size are associated with knee pain using a within-person, between-knee study design.

Methods

We studied 53 subjects (19 men, 34 women) from the Osteoarthritis Initiative, with identical radiographic OA grades in both knees, but frequent pain in one and no pain in the other knee. The tibial plateau and menisci were analyzed using coronally reconstructed double echo steady-state sequence with water excitation (DESSwe) MRI.

Results

The medial meniscus covered a smaller proportion of the tibial plateau (−5%) and displayed greater extrusion of the body (+15%) in painful than in painless knees (paired t-test; p < 0.05). The external margin of the lateral meniscus showed greater extrusion of the body in painful knees (+22%; p = 0.03), but no significant difference in the position of its internal margin or tibial coverage. Medial or lateral extrusion ≥3 mm was more frequent in painful (n = 23) than in painless knees (n = 12; McNemar’s test; p = 0.02). No significant association was observed between meniscal size and knee pain.

Conclusions

These data suggest a relationship between extrusion of the meniscal body, as measured with quantitative MRI, and knee pain in subjects with knee OA. Further studies need to confirm these findings and their clinical relevance.

Key Points

  • Meniscal segmentation provides quantitative measures of meniscal size/position

  • Between-knee, within-person approaches can explore potential sources of knee pain

  • Meniscal extrusion may be a potential source of knee pain