Evaluation of Medial Meniscal Thickness, Tear and Extrusion in Patients with and without Osteoarthritis of Knee: A Cross-sectional Study
Correspondence Address :
Senthil Kumar Aiyappan,
Department of Radiology, SRM Medical College, Hospital and Research Centre,
Kattankulathur, Chengalpattu, Tamil Nadu, India.
E-mail: asenthilkumarpgi@gmail.com
Introduction: Loss of articular cartilage is the primary change occurring in osteoarthritis. However, due to combination of several cellular changes and biomechanics stresses, several secondary changes like formation of osteophytes, development of bone osteophytes, synovial and capsular changes, meniscal tears and extrusion also occur. A meniscal lesion in a healthy knee joint may eventually lead to the development of knee osteoarthritis, but an osteoarthritic knee may also lead to meniscal damage which in turn can further accelerate the disease process. It is often concluded to be a two-way relationship.
Aim: To assess medial meniscal thickness and incidence of medial meniscal tear, extrusion in patients with knee osteoarthritis and also to assess cartilage damage in knee osteoarthritis patients in comparison to normal patients.
Materials and Methods: A cross-sectional study was in the Department of Radiodiagnosis, SRM Medical College, Hospital and Research Centre, Tamil Nadu, India, in 180 subjects, out of which 90 had osteoarthritis and 90 were controls. Patients were evaluated radiographically using anteroposterior and lateral projections in plain X-ray following which patient’s knees were imaged using routine Magnetic Resonance Imaging (MRI) protocols. The thickness of anterior horn, posterior horn and body of medial meniscus was assessed manually in sagittal Proton Density Fat Saturation (PDFS) sequence images. The signal intensity changes within the menisci was assessed and graded accordingly. Meniscal tear associated with meniscal extrusion was also assessed. The articular cartilage thickness was measured in coronal PDFS images. Data was analysed using Chi-square test for qualitative analysis and unpaired t-test for quantitative analysis.
Results: The mean medial meniscal thickness of anterior horn, body and posterior horn was 3.95 mm, 3.57 mm, 3.53 mm in patients with osteoarthritis; while those for patients without osteoarthritis was 5.65 mm, 6.05 mm, 6.56 mm (p-value of 0.021, 0.032, 0.029, respectively). The medial meniscal tear was seen in 46 patients with osteoarthritis and 40 without osteoarthritis (p-value=0.018). The meniscal extrusion was nil, less than 50% and more than 50% in 39, 34 and 17 patients with osteoarthritis; while those for the other group was 72, 14 and four (p-value <0.001, 0.001 and 0.003, respectively). The mean medial tibial articular cartilage thickness was 1.86 mm in patients with osteoarthritis and 2.04 mm in patients without osteoarthritis (p-value=0.009), and the mean femoral articular cartilage thickness was 1.84 mm in patients with osteoarthritis and 2.02 mm in patients without osteoarthritis (p-value=0.010).
Conclusion: The study concludes that the incidence of meniscal tear, extrusion, and cartilage damage is more common in patients with knee osteoarthritis. Further research is needed to provide proficient knowledge and to improve the quality of life in patients suffering from knee osteoarthritis.
Knee pain, Magnetic resonance imaging, Radiograph
DOI: 10.7860/JCDR/2021/50637.15752
Date of Submission: Jun 01, 2021
Date of Peer Review: Sep 20, 2021
Date of Acceptance: Oct 12, 2021
Date of Publishing: Dec 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
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• iThenticate Software: Oct 23, 2021 (6%)
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