Meniscal damage associated with increased local subchondral bone mineral density: a Framingham study.
OBJECTIVE
Because menisci and the medial vs lateral tibial plateau bone mineral density ratio (M:L BMD) are associated with loading within the knee, we postulated there to be an association between compartment-specific meniscal damage and M:L BMD. We hypothesized that knees with higher M:L BMD, consistent with increased medial subchondral BMD, would be associated with medial meniscal damage, and lower ratios with lateral meniscal damage.


METHODS
We conducted a cross-sectional study evaluating participants in the Framingham Osteoarthritis Cohort having magnetic resonance images (MRIs), BMDs, and x-rays of the knee. Medial and lateral meniscal damage were defined on MRI. We performed a logistic regression with medial meniscal damage as the outcome testing M:L BMD groups as predictor variables. We adjusted for age and sex; we used generalized estimating equations (GEE) to adjust for correlation between knees. Identical analyses were performed evaluating lateral meniscal damage.


RESULTS
When evaluating the relation of M:L BMD to medial meniscal damage, the odds ratios (ORs) of prevalent medial meniscal damage from lowest to highest quartile of M:L BMD were 1.0 (referent), 1.9, 2.4 and 8.9, P for trend <0.0001. When evaluating the relation of M:L BMD to lateral meniscal damage, the ORs of prevalent lateral meniscal damage from lowest to highest quartile of M:L BMD were 1.0 (referent), 0.3, 0.2, and 0.2, P for trend = 0.001.


CONCLUSIONS
Meniscal damage is associated with higher regional tibial BMD in the same compartment. Our findings highlight the close relationship between meniscal integrity and regional tibial subchondral BMD.
Lo
G H
GH
Tufts - New England Medical Center, Boston, MA 02111, USA. glo@tufts-nemc.org
Niu
J
J
McLennan
C E
CE
Kiel
D P
DP
McLean
R R
RR
Guermazi
A
A
Genant
H K
HK
McAlindon
T E
TE
Hunter
D J
DJ
D000368:Aged; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology*; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology*; D000070600:Tibial Meniscus Injuries