title: Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging.
abstract: BACKGROUND
  The relation between knee meniscal structural damage and cartilage degradation is plausible but not yet clearly proven.
  
  
  OBJECTIVE
  To quantitate the cartilage volume changes in knee osteoarthritis using magnetic resonance imaging (MRI), and determine whether meniscal alteration predicts cartilage volume loss over time.
  
  
  METHODS
  32 patients meeting ACR criteria for symptomatic knee osteoarthritis were studied. MRI knee acquisitions were done every six months for two years. The cartilage volumes of different knee regions were measured. Three indices of structural change in the medial and lateral menisci were evaluated--degeneration, tear, and extrusion--using a semiquantitative scale.
  
  
  RESULTS
  24 patients (75%) had mild to moderate or severe meniscal damage (tear or extrusion) at baseline. A highly significant difference in global cartilage volume loss was observed between severe medial meniscal tear and absence of tear (mean (SD), -10.1 (2.1)% v -5.1 (2.4)%, p = 0.002). An even greater difference was found between the medial meniscal changes and medial compartment cartilage volume loss (-14.3 (3.0)% in the presence of severe tear v -6.3 (2.7)% in the absence of tear; p<0.0001). Similarly, a major difference was found between the presence of a medial meniscal extrusion and loss of medial compartment cartilage volume (-15.4 (4.1)% in the presence of extrusion v -4.5 (1.7)% with no extrusion; p<0.001).
  
  
  CONCLUSIONS
  Meniscal tear and extrusion appear to be associated with progression of symptomatic knee osteoarthritis.
authors.affiliation: Centre hospitalier de l'Université de Montréal, Department of Radiology, Notre-Dame Hospital, Quebec, Canada.
authors.forename: M-J
authors.initials: MJ
authors.lastname: Berthiaume
authors.forename: J-P
authors.initials: JP
authors.lastname: Raynauld
authors.forename: J
authors.initials: J
authors.lastname: Martel-Pelletier
authors.forename: F
authors.initials: F
authors.lastname: Labonté
authors.forename: G
authors.initials: G
authors.lastname: Beaudoin
authors.forename: D A
authors.initials: DA
authors.lastname: Bloch
authors.forename: D
authors.initials: D
authors.lastname: Choquette
authors.forename: B
authors.initials: B
authors.lastname: Haraoui
authors.forename: R D
authors.initials: RD
authors.lastname: Altman
authors.forename: M
authors.initials: M
authors.lastname: Hochberg
authors.forename: J M
authors.initials: JM
authors.lastname: Meyer
authors.forename: G A
authors.initials: GA
authors.lastname: Cline
authors.forename: J-P
authors.initials: JP
authors.lastname: Pelletier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000209:etiology / Q000473:pathology*; D010865:Pilot Projects; D012044:Regression Analysis; D000070600:Tibial Meniscus Injuries