Partial meniscectomy is associated with increased risk of incident radiographic osteoarthritis and worsening cartilage damage in the following year
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To assess whether partial meniscectomy is associated with increased risk of radiographic osteoarthritis (ROA) and worsening cartilage damage in the following year.
We studied 355 knees from the Osteoarthritis Initiative that developed ROA (Kellgren-Lawrence grade ≥ 2), which were matched with control knees. The MR images were assessed using the semi-quantitative MOAKS system. Conditional logistic regression was applied to estimate risk of incident ROA. Logistic regression was used to assess the risk of worsening cartilage damage in knees with partial meniscectomy that developed ROA.
In the group with incident ROA, 4.4 % underwent partial meniscectomy during the year prior to the case-defining visit, compared with none of the knees that did not develop ROA. All (n = 31) knees that had partial meniscectomy and 58.9 % (n = 165) of the knees with prevalent meniscal damage developed ROA (OR = 2.51, 95 % CI [1.73, 3.64]). In knees that developed ROA, partial meniscectomy was associated with an increased risk of worsening cartilage damage (OR = 4.51, 95 % CI [1.53, 13.33]).
The probability of having had partial meniscectomy was higher in knees that developed ROA. When looking only at knees that developed ROA, partial meniscectomy was associated with greater risk of worsening cartilage damage.
• Partial meniscectomy is a controversial treatment option for degenerative meniscal tears.
• Partial meniscectomy is strongly associated with incident osteoarthritis within 1 year.
• Partial meniscectomy is associated with increased risk of worsening cartilage damage.
KeywordsMeniscus Partial meniscectomy Cartilage loss MRI Osteoarthritis
Magnetic resonance imaging
Randomized controlled trial
OAI annual visit when radiographic osteoarthritis was diagnosed
OAI annual visit 1 year prior to diagnosis of radiographic osteoarthritis
The scientific guarantor of this publication is the first author, Frank Roemer. The data were presented at RSNA and at ECR 2015 as a podium presentation.
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
The authors of this manuscript declare relationships with the following companies outside of this work: Dr. Guermazi has received consultancies, speaking fees, and/or honoraria from OrthoTrophix, Genzyme, Merck Serono and TissueGene, and is President and shareholder of Boston Imaging Core Lab (BICL), LLC, a company providing image assessment services. Dr. Roemer is Chief Medical Officer and shareholder of BICL, LLC. Dr. Kwoh has provided consulting services to Novartis and has received research support from AstraZeneca. Dr. Eckstein is CEO of Chondrometrics GmbH, a company providing MR image analysis services to academic researchers and to industry. He provides consulting services to Merck Serono, Novartis, and Sanofi-Aventis, has received speaker honoraria from Merck, Glaxo-Smith-Kline, Genzyme, Medtronic, and Synthes, and has received research support from Pfizer, Eli Lilly, Merck Serono, Glaxo-Smith-Kline, Centocor R&D, Wyeth, Novartis, and Stryker. Dr. Hunter receives royalties from DJO.
The study and image acquisition was funded by the OAI, a public–private partnership comprising five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners of the OAI include Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health.
The image analysis in this study was funded in part by a contract with the University of Pittsburgh (Pivotal OAI MRI Analyses [POMA]: NIH/NHLBI Contract No. HHSN2682010000 21C), and in part by a vendor contract from the OAI coordinating center at the University of California, San Francisco (N01-AR-2-2258).
The statistical data analysis was funded in part by a contract with the University of Pittsburgh (Pivotal OAI MRI Analyses [POMA]: NIH/NHLBI Contract No. HHSN2682010000 21C) and by the University of Pittsburgh Multidisciplinary Clinical Research Center (MCRC) for Rheumatic and Musculoskeletal Diseases (P60 AR054731).
Michael J. Hannon, Jason Grago and Robert Boudreau have significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, case–control study, multicenter study.
- 14.Nevitt MC, Felson DT, Lester G. The Osteoarthritis Initiative: protocol for the cohort study. p. 19–20. URL: http://oai.epi-ucsf.org/datarelease/docs/StudyDesignProtocol.pdf. Accessed June 23, 2015
- 15.Radiographic procedure manual for examinations of the knee, hand, pelvis and lower limbs. Version 2.1. August 2006. URL: http://oai.epi-ucsf.org/datarelease/operationsManuals/RadiographicManual.pdf. Accessed June 23, 2015
- 17.Appendix A. Project 15: reader discrepancies and adjudication procedures. OAI central reading of knee x-rays for K-L grade and individual features of knee OA 2013; p. 8. URL: http://oai.epi-ucsf.org/datarelease/forms/kXR_SQ_BU_Descrip.pdf?V01XRKL. Accessed June 23, 2015
- 23.Englund M, Guermazi A, Roemer FW, et al (2009) Meniscal tear in knees without surgery and the development of radiographic osteoarthritis among middle-aged and elderly persons: The Multicenter Osteoarthritis Study. Arthritis RheumGoogle Scholar