title: Meniscal extrusion and bone marrow lesions are associated with incident and progressive knee osteoarthritis.
abstract: Whether meniscal extrusion and bone marrow lesions (BMLs) are independently associated with the risk of knee osteoarthritis (OA) is unknown.
  
  
  
  Data was extracted from the Osteoarthritis Initiative (OAI) cohort. Participants were grouped according to the absence (Kellgren-Lawrence (KL) grade ≤ 1, n = 2120) or presence (KL ≥ 2, n = 2249) of radiographic OA (ROA). Baseline meniscal extrusion and tibial BMLs were assessed. Tibial plateau cartilage volume was assessed at baseline and 72 months, while radiographic disease was assessed at baseline and 48 months. Total knee replacement (TKR) was assessed at 72 months.
  
  
  
  In those with ROA, the presence of a baseline meniscal extrusion (independent of BMLs) was associated with accelerated cartilage volume loss (medial tibia: -2.1%/annum vs -1.5%; lateral: -2.6%/annum vs -1.6%; both P < 0.001), progressive ROA and TKR (Odds ratio (OR) range 1.4-1.8; 95% CI range 1.1-2.9). The presence of a baseline BML was associated with accelerated cartilage volume loss (medial tibia: -2.1%/annum vs -1.6%; lateral: -1.9%/annum vs -1.6%; P ≤ 0.02), progressive ROA and joint replacement (OR range 1.5-2.4; 95% CI range 1.1-3.4). In those with no ROA, a baseline medial meniscal extrusion was associated with accelerated cartilage volume loss (medial tibia: -2.1%/annum vs -1.2%, P < 0.001), and a baseline medial BML with incident ROA (OR 1.7, 95% CI 1.1 to 2.9).
  
  
  
  The presence of baseline meniscal extrusion and BMLs are associated with incident and progressive knee of each other (OA) and represent important structural targets for the treatment and prevention of knee OA.
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia; Baker IDI Heart and Diabetes Institute, Commercial Road, Melbourne, VIC 3004, Australia. Electronic address: andrew.teichtahl@monash.edu.
authors.forename: A J
authors.initials: AJ
authors.lastname: Teichtahl
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia.
authors.forename: F M
authors.initials: FM
authors.lastname: Cicuttini
authors.affiliation: Medical Imaging Research & Development, ArthroLab Inc., Montreal, Quebec, Canada.
authors.forename: F
authors.initials: F
authors.lastname: Abram
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
authors.forename: J-P
authors.initials: JP
authors.lastname: Pelletier
authors.affiliation: Medical Imaging Research & Development, ArthroLab Inc., Montreal, Quebec, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Dodin
authors.affiliation: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Martel-Pelletier
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001855:Bone Marrow Diseases / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D002357:Cartilage Diseases / Q000473:pathology / Q000503:physiopathology; D002358:Cartilage, Articular / Q000473:pathology / Q000502:physiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment
keywords: Arthroplasty; Osteoarthritis; Outcome measures; Risk assessment; Structure