2023, Vol. 27 ›› Issue (4): 600-605

Meniscus extrusion and patellofemoral joint cartilage injury and bone marrow lesions: MRI semi-quantitative score

Guo Yingqi, Gong Xianxu, Zhang Yan, Xiao Han, Wang Ye, Gu Wenguang   

Abstract: BACKGROUND: The research on the effect of meniscus injury on knee osteoarthritis is mostly concentrated in the tibiofemoral compartment. There are reports on the correlation between meniscus extrusion and patellofemoral osteoarthritis outside China, but there are few related studies in China.
OBJECTIVE: To explore the association between meniscus extrusion and patellofemoral osteoarthritis based on published data from the Osteoarthritis Initiative.
METHODS: Totally 1 109 participants with complete MRI Osteoarthritis Knee Score and other clinical information at baseline were selected. Meniscal tear, maceration, extrusion, patellofemoral cartilage and bone marrow lesions were scored by MRI Osteoarthritis Knee Score semi-quantitative scoring system. Gender, age, race, body mass index, history of knee injury, and history of surgery were collected by questionnaire. Logistic regression analysis was used to determine the relationship between meniscal extrusion and patellofemoral osteoarthritis.
RESULTS AND CONCLUSION: (1) The cross-sectional study showed that patients with medial and lateral meniscus extrusion had a high incidence of any cartilage injury, full-thickness cartilage injury, and bone marrow lesions in medial and lateral patellofemoral joint. (2) Logistic regression analysis showed that after adjusting for confounding factors (adjustment model 2), the medial meniscus extrusion was positively correlated with any cartilage injury of the medial patellofemoral joint [OR: 2.4(95% CI: 1.6, 3.6)] and full-thickness cartilage injury [OR: 1.5(95% CI: 1.0, 2.1)]; there was no correlation between medial meniscus extrusion and medial patellofemoral joint bone marrow lesions without adjustment [OR: 0.8(95% CI: 0.6, 1.1)] and after adjustment for confounding factors [OR: 1.3(95% CI: 0.9, 1.8)]. (3) After adjusting for confounding factors (adjustment model 2), lateral meniscus extrusion was positively correlated with any cartilage injury of the lateral patellofemoral joint [OR: 2.1(95% CI: 1.0, 4.5)] and full-thickness cartilage injury [OR: 2.3(95% CI:1.1, 4.6)]; while without adjusting for confounding factors [OR: 1.7(95% CI: 1.0, 2.9)], lateral meniscus extrusion was positively correlated with bone marrow lesions of the lateral patellofemoral joint, but not after adjustment for confounding factors [OR: 1.1(95% CI: 0.6, 2.1)]. (4) Meniscus extrusion was positively correlated with cartilage injury of patellofemoral joint among Americans based on published data from the Osteoarthritis Initiative.
Key words: meniscal extrusion, meniscus injury, patellofemoral osteoarthritis, knee osteoarthritis, magnetic resonance imaging, cross-sectional study, cartilage injury