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Partial meniscectomy is associated with increased risk of incident radiographic osteoarthritis and worsening cartilage damage in the following year

  • Musculoskeletal
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Abstract

Objectives

To assess whether partial meniscectomy is associated with increased risk of radiographic osteoarthritis (ROA) and worsening cartilage damage in the following year.

Methods

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.

Results

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]).

Conclusions

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.

Key Points

• 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.

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Abbreviations

MRI:

Magnetic resonance imaging

ROA:

Radiographic osteoarthritis

RCT:

Randomized controlled trial

OAI:

Osteoarthritis Initiative

K-L:

Kellgren-Lawrence

P0:

OAI annual visit when radiographic osteoarthritis was diagnosed

P-1:

OAI annual visit 1 year prior to diagnosis of radiographic osteoarthritis

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Acknowledgments

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.

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Authors and Affiliations

  1. Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rd floor, 820 Harrison Avenue, Boston, MA, 02118, USA

    Frank W. Roemer & Ali Guermazi

  2. Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054, Erlangen, Germany

    Frank W. Roemer

  3. University of Arizona Arthritis Center & University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, 85724, USA

    C. Kent Kwoh

  4. Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, S700 Biomedical Science Tower, 3500 Terrace Street, Pittsburgh, PA, 15261, USA

    Michael J. Hannon & Jason Grago

  5. Department of Rheumatology, Royal North Shore Hospital and Kolling Institute, University of Sydney, Pacific Hwy, St Leonards, NSW 2065, Australia

    David J. Hunter

  6. Institute of Anatomy, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria

    Felix Eckstein

  7. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA

    Robert M. Boudreau

  8. Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund, Lund University, Klinikgatan 22, SE-221 85, Lund, Sweden

    Martin Englund

Authors
  1. Frank W. Roemer
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  2. C. Kent Kwoh
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  3. Michael J. Hannon
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  7. Robert M. Boudreau
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  8. Martin Englund
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  9. Ali Guermazi
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Corresponding author

Correspondence to Frank W. Roemer.

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Roemer, F.W., Kwoh, C.K., Hannon, M.J. et al. Partial meniscectomy is associated with increased risk of incident radiographic osteoarthritis and worsening cartilage damage in the following year. Eur Radiol 27, 404–413 (2017). https://doi.org/10.1007/s00330-016-4361-z

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  • DOI: https://doi.org/10.1007/s00330-016-4361-z

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