Association of quantitative measures of medial meniscal extrusion with structural and symptomatic knee osteoarthritis progression – Data from the OAI FNIH biomarker study

K. Sharma; F. Eckstein; S. Maschek; M. Roth; D.J. Hunter; W. Wirth

doi:10.1016/j.joca.2023.07.007

Association of quantitative measures of medial meniscal extrusion with structural and symptomatic knee osteoarthritis progression – Data from the OAI FNIH biomarker study

K. Sharma
, F. Eckstein
, S. Maschek
, M. Roth
, D.J. Hunter
, W. Wirth

Health Sciences

Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology, Paracelsus Medical University Salzburg and Nuremberg
Department of Anatomy, Kathmandu University School of Medical Sciences
Chondrometrics GmbH
Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University
Rheumatology Department, Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To study the association of quantitative medial meniscal position measures with radiographic and symptomatic knee osteoarthritis (OA) progression over 2–4 years. Methods: The FNIH OAI Biomarkers study comprised 600 participants in four subgroups: 194 case knees with combined structural (medial minimum joint space width (minJSW) loss ≥0.7 mm) and symptomatic (persistent Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale increase ≥9 [0–100 scale]) progression; 200 knees with neither structural nor symptomatic progression; 103 knees with isolated structural and 103 with isolated symptomatic progression. Coronal double echo at steady state (DESS) MRIs were used for segmenting five central slices of the medial meniscus. Associations with progression were examined using logistic regression (adjusted for demographic and clinical data). Results: Greater baseline medial meniscal extrusion was associated with combined structural/symptomatic progression (OR 1.59; 95%CI: [1.25,2.04]). No relationship was observed for tibial plateau coverage or meniscal overlap distance. The two-year increase in meniscal extrusion (OR 1.48 [1.21, 1.83]), and reduction in tibial plateau coverage (OR 0.70 [0.58,0.86]) and overlap distance (OR 0.73 [0.60,0.89]) were associated with combined progression. Greater baseline extrusion was associated with isolated structural and less extrusion with isolated symptomatic progression. The longitudinal increase in meniscal extrusion, and reduction in tibial plateau coverage and overlap distance were associated with structural, but not with symptomatic progression. Conclusion: Baseline measures of medial meniscal extrusion were consistently positively associated with combined radiographic/symptomatic progression and with isolated structural, but not with isolated symptomatic progression. These measures may therefore allow one to assess the risk of structural knee OA progression and to monitor interventions restoring meniscal position and function.

Original language	English
Pages (from-to)	1396-1404
Number of pages	9
Journal	Osteoarthritis Cartilage
Volume	31
Issue number	10
DOIs	https://doi.org/10.1016/j.joca.2023.07.007
Publication status	Published - 2023

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Knee
Meniscus extrusion
MRI
Osteoarthritis
Progression
biological marker
adult
Article
case control study
clinical feature
controlled study
disease exacerbation
female
human
knee osteoarthritis
knee radiography
major clinical study
male
medial meniscal extrusion
middle aged
musculoskeletal system parameters
nuclear magnetic resonance imaging
quantitative study
risk factor
Western Ontario and McMaster Universities Osteoarthritis Index
diagnostic imaging
knee
knee meniscus
tibia
Disease Progression
Humans
Knee Joint
Magnetic Resonance Imaging
Menisci, Tibial
Meniscus
Osteoarthritis, Knee
Tibia

Classification according to Österreichische Systematik der Wissenschaftszweige (ÖFOS 2012)

303012 Health sciences

Applied Research Level (ARL)

Not applicable

Research focus/foci

Applied Health Innovation

Access to Document

10.1016/j.joca.2023.07.007

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85168322904&doi=10.1016%2fj.joca.2023.07.007&partnerID=40&md5=f9fa146b2447ff3d25ebd00183003531

Cite this

@article{a36af25736cd4ddab6ab89d9a80cd533,

title = "Association of quantitative measures of medial meniscal extrusion with structural and symptomatic knee osteoarthritis progression – Data from the OAI FNIH biomarker study",

abstract = "Objective: To study the association of quantitative medial meniscal position measures with radiographic and symptomatic knee osteoarthritis (OA) progression over 2–4 years. Methods: The FNIH OAI Biomarkers study comprised 600 participants in four subgroups: 194 case knees with combined structural (medial minimum joint space width (minJSW) loss ≥0.7 mm) and symptomatic (persistent Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale increase ≥9 [0–100 scale]) progression; 200 knees with neither structural nor symptomatic progression; 103 knees with isolated structural and 103 with isolated symptomatic progression. Coronal double echo at steady state (DESS) MRIs were used for segmenting five central slices of the medial meniscus. Associations with progression were examined using logistic regression (adjusted for demographic and clinical data). Results: Greater baseline medial meniscal extrusion was associated with combined structural/symptomatic progression (OR 1.59; 95\%CI: [1.25,2.04]). No relationship was observed for tibial plateau coverage or meniscal overlap distance. The two-year increase in meniscal extrusion (OR 1.48 [1.21, 1.83]), and reduction in tibial plateau coverage (OR 0.70 [0.58,0.86]) and overlap distance (OR 0.73 [0.60,0.89]) were associated with combined progression. Greater baseline extrusion was associated with isolated structural and less extrusion with isolated symptomatic progression. The longitudinal increase in meniscal extrusion, and reduction in tibial plateau coverage and overlap distance were associated with structural, but not with symptomatic progression. Conclusion: Baseline measures of medial meniscal extrusion were consistently positively associated with combined radiographic/symptomatic progression and with isolated structural, but not with isolated symptomatic progression. These measures may therefore allow one to assess the risk of structural knee OA progression and to monitor interventions restoring meniscal position and function.",

keywords = "Knee, Meniscus extrusion, MRI, Osteoarthritis, Progression, biological marker, adult, Article, case control study, clinical feature, controlled study, disease exacerbation, female, human, knee osteoarthritis, knee radiography, major clinical study, male, medial meniscal extrusion, middle aged, musculoskeletal system parameters, nuclear magnetic resonance imaging, quantitative study, risk factor, Western Ontario and McMaster Universities Osteoarthritis Index, diagnostic imaging, knee, knee meniscus, tibia, Disease Progression, Humans, Knee Joint, Magnetic Resonance Imaging, Menisci, Tibial, Meniscus, Osteoarthritis, Knee, Tibia",

author = "K. Sharma and F. Eckstein and S. Maschek and M. Roth and D.J. Hunter and W. Wirth",

note = "Export Date: 14 December 2023 CODEN: OSCAE Correspondence Address: Wirth, W.; Institute of Anatomy and Cell Biology, Strubergasse 21, Austria; email: [email protected] Funding details: National Institutes of Health, NIH, HHSN2682010000, N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, N01-AR-2-2262 Funding details: Foundation for the National Institutes of Health, FNIH Funding details: U.S. Department of Health and Human Services, HHS Funding details: Arthritis Foundation, AF Funding details: Pfizer Funding details: GlaxoSmithKline, GSK Funding details: Osteoarthritis Research Society International, OARSI Funding text 1: Scientific and financial support for the FNIH OA Biomarkers Consortium were made possible through grants, direct and in-kind contributions provided by: AbbVie; Amgen Inc.; Arthritis Foundation; Bioiberica S.A.; DePuyMitek, Inc.; Flexion Therapeutics, Inc.; GlaxoSmithKline; Merck Serono; Rottapharm | Madaus; Sanofi; Stryker; The Pivotal OAI MRI Analyses (POMA) Study, NIH HHSN2682010000. We thank the Osteoarthritis Research Society International (OARSI) for their leadership and expertise on the FNIH OA Biomarker Consortium project. The OAI, a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262), was funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners of the OAI include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. The Ph.D. project of Kalpana Sharma is funded by a grant from the Rotary Club Salzburg-Paracelsus. Funding text 2: Scientific and financial support for the FNIH OA Biomarkers Consortium were made possible through grants, direct and in-kind contributions provided by: AbbVie; Amgen Inc.; Arthritis Foundation; Bioiberica S.A.; DePuyMitek, Inc.; Flexion Therapeutics, Inc.; GlaxoSmithKline; Merck Serono; Rottapharm | Madaus; Sanofi; Stryker; The Pivotal OAI MRI Analyses (POMA) Study, NIH HHSN2682010000 . We thank the Osteoarthritis Research Society International (OARSI) for their leadership and expertise on the FNIH OA Biomarker Consortium project. The OAI, a public-private partnership comprised of five contracts ( N01-AR-2-2258 ; N01-AR-2-2259 ; N01-AR-2-2260 ; N01-AR-2-2261 ; N01-AR-2-2262 ), was funded by the National Institutes of Health , a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners of the OAI include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. The Ph.D. project of Kalpana Sharma is funded by a grant from the Rotary Club Salzburg-Paracelsus. References: Englund, M., Guermazi, A., Gale, D., Hunter, D.J., Aliabadi, P., Clancy, M., Incidental meniscal findings on knee MRI in middle-aged and elderly persons (2008) N Engl J Med, 359 (11), pp. 1108-1115; Raynauld, J.P., Martel-Pelletier, J., Haraoui, B., Choquette, D., Dorais, M., Wildi, L.M., Risk factors predictive of joint replacement in a 2-year multicentre clinical trial in knee osteoarthritis using MRI: results from over 6 years of observation (2011) Ann Rheum Dis, 70 (8), pp. 1382-1388; Roth, M., Emmanuel, K., Wirth, W., Kwoh, C.K., Hunter, D.J., Hannon, M.J., Changes in medial meniscal three-dimensional position and morphology as predictors of knee replacement in rapidly progressing knee osteoarthritis: data from the osteoarthritis initiative (2021) Arthritis Care Res, 73 (7), pp. 1031-1037; Foreman, S.C., Liu, Y., Nevitt, M.C., Neumann, J., Joseph, G.B., Lane, N.E., Meniscal root tears and extrusion are significantly associated with the development of accelerated knee osteoarthritis: data from the osteoarthritis initiative (2021) Cartilage, 13, pp. 239S-248S; Voet, J.A.V.D., Runhaar, J., Plas, P.V.D., Vroegindeweij, D., Oei, E.H., Bierma-zeinstra, S.M.A., Baseline meniscal extrusion associated with incident knee osteoarthritis after 30 months in overweight and obese women (2017) Osteoarthr Cartil, 25 (8), pp. 1299-1303; Biswal, S., Hastie, T., Andriacchi, T.P., Bergman, G.A., Dillingham, M.F., Lang, P., Risk factors for progressive cartilage loss in the knee: a longitudinal magnetic resonance imaging study in forty-three patients (2002) Arthritis Rheum, 46 (11), pp. 2884-2892; Berthiaume, M.J., Raynauld, J.P., Martel-Pelletier, J., Labont{\'e}, F., Beaudoin, G., Bloch, D.A., Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging (2005) Ann Rheum Dis, 64 (4), pp. 556-563; Guermazi, A., Eckstein, F., Hayashi, D., Roemer, F.W., Wirth, W., Yang, T., Baseline radiographic osteoarthritis and semi-quantitatively assessed meniscal damage and extrusion and cartilage damage on MRI is related to quantitatively defined cartilage thickness loss in knee osteoarthritis: the Multicenter Osteoarthritis Study (2015) Osteoarthr Cartil, 23, p. 12; Chang, A., Moisio, K., Chmiel, J.S., Eckstein, F., Guermazi, A., Almagor, O., Subregional effects of meniscal tears on cartilage loss over 2 years in knee osteoarthritis (2011) Ann Rheum Dis, 70 (1), pp. 74-79; Bloecker, K., Wirth, W., Guermazi, A., Hunter, D.J., Resch, H., Hochreiter, J., Relationship between medial meniscal extrusion and cartilage loss in specific femorotibial subregions: data from the osteoarthritis initiative (2015) Arthritis Care Res, 67, p. 11; Roemer, F.W., Kwoh, C.K., Hannon, M.J., Hunter, D.J., Eckstein, F., Fujii, T., What comes first? Multi-tissue involvement leading to radiographic osteoarthritis: MRI-based trajectory analysis over 4 years in the osteoarthritis initiative (2015) Arthritis Rheumatol, 67 (8), pp. 2085-2096; Wenger, A., Wirth, W., Hudelmaier, M., Noebauer-Huhmann, I., Trattnig, S., Bloecker, K., Meniscus body position, size, and shape in persons with and persons without radiographic knee osteoarthritis: quantitative analyses of knee magnetic resonance images from the osteoarthritis initiative (2013) Arthritis Rheum, 65 (7), pp. 1804-1811; Emmanuel, K., Quinn, E., Niu, J., Guermazi, A., Roemer, F., Wirth, W., Quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis - data from the osteoarthritis initiative (2016) Osteoarthr Cartil, 24 (2), pp. 262-269; Peterfy, C.G., Guermazi, A., Zaim, S., Tirman, P.F., Miaux, Y., White, D., Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis (2004) Osteoarthr Cartil, 12 (3), pp. 177-190; Hunter, D.J., Lo, G.H., Gale, D., Grainger, A.J., Guermazi, A., Conaghan, P.G., The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston-Leeds Osteoarthritis Knee Score) (2008) Ann Rheum Dis, 67 (2), pp. 206-211; Hunter, D.J., Guermazi, A., Lo, G.H., Grainger, A.J., Conaghan, P.G., Boudreau, R.M., Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score) (2011) Osteoarthr Cartil, 19 (8), pp. 990-1002; Hunter, D.J., Zhang, Y.Q., Tu, X., Lavalley, M., Niu, J.B., Amin, S., Change in joint space width: hyaline articular cartilage loss or alteration in meniscus? (2006) Arthritis Rheum, 54 (8), pp. 2488-2495; Hunter, D.J., Zhang, Y.Q., Niu, J.B., Tu, X., Amin, S., Clancy, M., The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis (2006) Arthritis Rheum, 54 (3), pp. 795-801; Liu, Y., Joseph, G.B., Foreman, S.C., Li, X., Lane, N.E., Nevitt, M.C., Determining a threshold of medial meniscal extrusion for prediction of knee pain and cartilage damage progression over 4 years: data from the osteoarthritis initiative (2021) Am J Roentgenol, 216 (5), pp. 1318-1328; Xu, D., van der Voet, J., Waarsing, J.H., Oei, E.H., Klein, S., Englund, M., Are changes in meniscus volume and extrusion associated to knee osteoarthritis development? A structural equation model (2021) Osteoarthr Cartil, 29 (10), pp. 1426-1431; Wirth, W., Frobell, R.B., Souza, R.B., Li, X., Wyman, B.T., Hellio Le Graverand, M.-P., A three-dimensional quantitative method to measure meniscus shape, position, and signal intensity using MR Images: a pilot study and preliminary results in knee osteoarthritis (2010) Magn Reson Med, 63 (5); Wenger, A., Englund, M., Wirth, W., Hudelmaier, M., Kwoh, K., Eckstein, F., Relationship of 3D meniscal morphology and position with knee pain in subjects with knee osteoarthritis: a pilot study (2012) Eur Radiol, 22 (1), pp. 211-220; Gao, K.T., Xie, E., Chen, V., Iriondo, C., Caliv{\`a}, F., Souza, R.B., Large-scale analysis of meniscus morphology as risk factor for knee osteoarthritis (2023) Arthritis Rheumatol; Sharma, K., Eckstein, F., Wirth, W., Emmanuel, K., Meniscus position and size in knees with versus without structural knee osteoarthritis progression: data from the osteoarthritis initiative (2022) Skeletal Radiol, 51 (5), pp. 997-1006; Ghouri, A., Robinson, E., Muzumdar, S., Barr, A., Murdoch, C., Kingsbury, S.R., A systematic review of the relationship between imaging-assessed meniscal pathologies, cartilage loss, joint replacement and pain in knee osteoarthritis (2022) Osteoarthr Cartil, 30 (10), pp. 1287-1327; Hunter, D.J., Nevitt, M., Losina, E., Kraus, V., Biomarkers for osteoarthritis: current position and steps towards further validation (2014) Best Pract Res Clin Rheumatol, 28 (1), pp. 61-71; Ornetti, P., Brandt, K., Hellio-Le Graverand, M.P., Hochberg, M., Hunter, D.J., Kloppenburg, M., OARSI-OMERACT definition of relevant radiological progression in hip/knee osteoarthritis (2009) Osteoarthr Cartil, 17 (7), pp. 856-863; Angst, F., Aeschlimann, A., Stucki, G., Smallest detectable and minimal clinically important differences of rehabilitation intervention with their implications for required sample sizes using WOMAC and SF-36 quality of life measurement instruments in patients with osteoarthritis of the lower ex (2001) Arthritis Rheum, 45 (4), pp. 384-391; Peterfy, C.G., Schneider, E., Nevitt, M., The osteoarthritis initiative: report on the design rationale for the magnetic resonance imaging protocol for the knee (2008) Osteoarthr Cartil, 16 (12), pp. 1433-1441; Schneider, E., NessAiver, M., White, D., Purdy, D., Martin, L., Fanella, L., The osteoarthritis initiative (OAI) magnetic resonance imaging quality assurance methods and results (2008) Osteoarthr Cartil, 16 (9), pp. 994-1004; Siorpaes, K., Wenger, A., Bloecker, K., Wirth, W., Hudelmaier, M., Eckstein, F., Interobserver reproducibility of quantitative meniscus analysis using coronal multiplanar DESS and IWTSE MR imaging (2012) Magn Reson Med, 67 (5), pp. 1419-1426; Kraus, V.B., Collins, J.E., Charles, H.C., Pieper, C.F., Whitley, L., Losina, E., Predictive validity of radiographic trabecular bone texture in knee osteoarthritis: the Osteoarthritis Research Society International/Foundation for the National Institutes of Health osteoarthritis biomarkers consortium (2018) Arthritis Rheumatol, 70 (1), pp. 80-87; Kraus, V.B., Collins, J.E., Hargrove, D., Losina, E., Nevitt, M., Katz, J.N., Predictive validity of biochemical biomarkers in knee osteoarthritis: data from the FNIH OA biomarkers consortium (2017) Ann Rheum Dis, 76 (1), pp. 186-195; Eckstein, F., Collins, J.E., Nevitt, M.C., Lynch, J.A., Kraus, V., Katz, J.N., Cartilage thickness change as an imaging biomarker of knee osteoarthritis progression - data from the fnih OA biomarkers consortium (2015) Arthritis Rheumatol; Hunter, D.J., Deveza, L.A., Collins, J.E., Losina, E., Nevitt, M.C., Roemer, F.W., Multivariable modeling of biomarker data from the phase 1 foundation for the NIH osteoarthritis biomarkers consortium (2022) Arthritis Care Res, 74 (7), pp. 1142-1153; Collins, J.E., Losina, E., Nevitt, M.C., Roemer, F.W., Guermazi, A., Lynch, J.A., Semi-quantitative imaging biomarkers of knee osteoarthritis progression: data from the FNIH OA biomarkers consortium (2016) Arthritis Rheumatol, 68 (10), pp. 2422-2431; Hunter, D., Nevitt, M., Lynch, J., Kraus, V.B., Katz, J.N., Collins, J.E., Longitudinal validation of periarticular bone area and 3D shape as biomarkers for knee OA progression? Data from the FNIH OA biomarkers consortium (2016) Ann Rheum Dis, 75 (9), pp. 1607-1614; Bloecker, K., Guermazi, A., Wirth, W., Benichou, O., Kwoh, C.K., Hunter, D.J., Tibial coverage, meniscus position, size and damage in knees discordant for joint space narrowing - data from the osteoarthritis initiative (2013) Osteoarthr Cartil, 21 (3); Okazaki, Y., Furumatsu, T., Yamaguchi, T., Kodama, Y., Kamatsuki, Y., Masuda, S., Medial meniscus posterior root tear causes swelling of the medial meniscus and expansion of the extruded meniscus: a comparative analysis between 2D and 3D MRI (2020) Knee Surg Sports Traumatol Arthrosc, 28 (11), pp. 3405-3415; Costa, C.R., Morrison, W.B., Carrino, J.A., Medial meniscus extrusion on knee MRI: Is extent associated with severity of degeneration or type of tear? (2004) Am J Roentgenol; Crema, M.D., Roemer, F.W., Felson, D.T., Englund, M., Wang, K., Jarraya, M., Factors associated with meniscal extrusion in knees with or at risk for osteoarthritis: the multicenter osteoarthritis study (2012) Radiology, 264 (2), pp. 494-503; Lee, D.H., Lee, B.S., Kim, J.M., Yang, K.S., Cha, E.J., Park, J.H., Predictors of degenerative medial meniscus extrusion: radial component and knee osteoarthritis (2011) Knee Surg Sports Traumatol Arthrosc, 19 (2), pp. 222-229; Roth, M., Wirth, W., Emmanuel, K., Culvenor, A.G., Eckstein, F., The contribution of 3D quantitative meniscal and cartilage measures to variation in normal radiographic joint space width—data from the osteoarthritis initiative healthy reference cohort (2017) Eur J Radiol, 87, pp. 90-98; Roth, M., Emmanuel, K., Wirth, W., Kwoh, C.K., Hunter, D.J., Eckstein, F., Sensitivity to change and association of three-dimensional meniscal measures with radiographic joint space width loss in rapid clinical progression of knee osteoarthritis (2018) Eur Radiol, 28, pp. 1844-1853; Roemer, F.W., Guermazi, A., Collins, J.E., Losina, E., Nevitt, M.C., Lynch, J.A., Semi-quantitative MRI biomarkers of knee osteoarthritis progression in the FNIH biomarkers consortium cohort − methodologic aspects and definition of change (2016) BMC Musculoskelet Disord, 17 (1), p. 466; Collins, J.E., Losina, E., Nevitt, M.C., Roemer, F.W., Guermazi, A., Lynch, J.A., Semiquantitative imaging biomarkers of knee osteoarthritis progression: data from the foundation for the National Institutes of Health osteoarthritis biomarkers consortium (2016) Arthritis Rheumatol, 68 (10), pp. 2422-2431",

year = "2023",

doi = "10.1016/j.joca.2023.07.007",

language = "English",

volume = "31",

pages = "1396--1404",

journal = "Osteoarthritis Cartilage",

issn = "1063-4584",

publisher = "W.B. Saunders Ltd",

number = "10",

}

TY - JOUR

T1 - Association of quantitative measures of medial meniscal extrusion with structural and symptomatic knee osteoarthritis progression – Data from the OAI FNIH biomarker study

AU - Sharma, K.

AU - Eckstein, F.

AU - Maschek, S.

AU - Roth, M.

AU - Hunter, D.J.

AU - Wirth, W.

N1 - Export Date: 14 December 2023 CODEN: OSCAE Correspondence Address: Wirth, W.; Institute of Anatomy and Cell Biology, Strubergasse 21, Austria; email: [email protected] Funding details: National Institutes of Health, NIH, HHSN2682010000, N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, N01-AR-2-2262 Funding details: Foundation for the National Institutes of Health, FNIH Funding details: U.S. Department of Health and Human Services, HHS Funding details: Arthritis Foundation, AF Funding details: Pfizer Funding details: GlaxoSmithKline, GSK Funding details: Osteoarthritis Research Society International, OARSI Funding text 1: Scientific and financial support for the FNIH OA Biomarkers Consortium were made possible through grants, direct and in-kind contributions provided by: AbbVie; Amgen Inc.; Arthritis Foundation; Bioiberica S.A.; DePuyMitek, Inc.; Flexion Therapeutics, Inc.; GlaxoSmithKline; Merck Serono; Rottapharm | Madaus; Sanofi; Stryker; The Pivotal OAI MRI Analyses (POMA) Study, NIH HHSN2682010000. We thank the Osteoarthritis Research Society International (OARSI) for their leadership and expertise on the FNIH OA Biomarker Consortium project. The OAI, a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262), was funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners of the OAI include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. The Ph.D. project of Kalpana Sharma is funded by a grant from the Rotary Club Salzburg-Paracelsus. Funding text 2: Scientific and financial support for the FNIH OA Biomarkers Consortium were made possible through grants, direct and in-kind contributions provided by: AbbVie; Amgen Inc.; Arthritis Foundation; Bioiberica S.A.; DePuyMitek, Inc.; Flexion Therapeutics, Inc.; GlaxoSmithKline; Merck Serono; Rottapharm | Madaus; Sanofi; Stryker; The Pivotal OAI MRI Analyses (POMA) Study, NIH HHSN2682010000 . We thank the Osteoarthritis Research Society International (OARSI) for their leadership and expertise on the FNIH OA Biomarker Consortium project. The OAI, a public-private partnership comprised of five contracts ( N01-AR-2-2258 ; N01-AR-2-2259 ; N01-AR-2-2260 ; N01-AR-2-2261 ; N01-AR-2-2262 ), was funded by the National Institutes of Health , a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners of the OAI include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. The Ph.D. project of Kalpana Sharma is funded by a grant from the Rotary Club Salzburg-Paracelsus. References: Englund, M., Guermazi, A., Gale, D., Hunter, D.J., Aliabadi, P., Clancy, M., Incidental meniscal findings on knee MRI in middle-aged and elderly persons (2008) N Engl J Med, 359 (11), pp. 1108-1115; Raynauld, J.P., Martel-Pelletier, J., Haraoui, B., Choquette, D., Dorais, M., Wildi, L.M., Risk factors predictive of joint replacement in a 2-year multicentre clinical trial in knee osteoarthritis using MRI: results from over 6 years of observation (2011) Ann Rheum Dis, 70 (8), pp. 1382-1388; Roth, M., Emmanuel, K., Wirth, W., Kwoh, C.K., Hunter, D.J., Hannon, M.J., Changes in medial meniscal three-dimensional position and morphology as predictors of knee replacement in rapidly progressing knee osteoarthritis: data from the osteoarthritis initiative (2021) Arthritis Care Res, 73 (7), pp. 1031-1037; Foreman, S.C., Liu, Y., Nevitt, M.C., Neumann, J., Joseph, G.B., Lane, N.E., Meniscal root tears and extrusion are significantly associated with the development of accelerated knee osteoarthritis: data from the osteoarthritis initiative (2021) Cartilage, 13, pp. 239S-248S; Voet, J.A.V.D., Runhaar, J., Plas, P.V.D., Vroegindeweij, D., Oei, E.H., Bierma-zeinstra, S.M.A., Baseline meniscal extrusion associated with incident knee osteoarthritis after 30 months in overweight and obese women (2017) Osteoarthr Cartil, 25 (8), pp. 1299-1303; Biswal, S., Hastie, T., Andriacchi, T.P., Bergman, G.A., Dillingham, M.F., Lang, P., Risk factors for progressive cartilage loss in the knee: a longitudinal magnetic resonance imaging study in forty-three patients (2002) Arthritis Rheum, 46 (11), pp. 2884-2892; Berthiaume, M.J., Raynauld, J.P., Martel-Pelletier, J., Labonté, F., Beaudoin, G., Bloch, D.A., Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging (2005) Ann Rheum Dis, 64 (4), pp. 556-563; Guermazi, A., Eckstein, F., Hayashi, D., Roemer, F.W., Wirth, W., Yang, T., Baseline radiographic osteoarthritis and semi-quantitatively assessed meniscal damage and extrusion and cartilage damage on MRI is related to quantitatively defined cartilage thickness loss in knee osteoarthritis: the Multicenter Osteoarthritis Study (2015) Osteoarthr Cartil, 23, p. 12; Chang, A., Moisio, K., Chmiel, J.S., Eckstein, F., Guermazi, A., Almagor, O., Subregional effects of meniscal tears on cartilage loss over 2 years in knee osteoarthritis (2011) Ann Rheum Dis, 70 (1), pp. 74-79; Bloecker, K., Wirth, W., Guermazi, A., Hunter, D.J., Resch, H., Hochreiter, J., Relationship between medial meniscal extrusion and cartilage loss in specific femorotibial subregions: data from the osteoarthritis initiative (2015) Arthritis Care Res, 67, p. 11; Roemer, F.W., Kwoh, C.K., Hannon, M.J., Hunter, D.J., Eckstein, F., Fujii, T., What comes first? Multi-tissue involvement leading to radiographic osteoarthritis: MRI-based trajectory analysis over 4 years in the osteoarthritis initiative (2015) Arthritis Rheumatol, 67 (8), pp. 2085-2096; Wenger, A., Wirth, W., Hudelmaier, M., Noebauer-Huhmann, I., Trattnig, S., Bloecker, K., Meniscus body position, size, and shape in persons with and persons without radiographic knee osteoarthritis: quantitative analyses of knee magnetic resonance images from the osteoarthritis initiative (2013) Arthritis Rheum, 65 (7), pp. 1804-1811; Emmanuel, K., Quinn, E., Niu, J., Guermazi, A., Roemer, F., Wirth, W., Quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis - data from the osteoarthritis initiative (2016) Osteoarthr Cartil, 24 (2), pp. 262-269; Peterfy, C.G., Guermazi, A., Zaim, S., Tirman, P.F., Miaux, Y., White, D., Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis (2004) Osteoarthr Cartil, 12 (3), pp. 177-190; Hunter, D.J., Lo, G.H., Gale, D., Grainger, A.J., Guermazi, A., Conaghan, P.G., The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston-Leeds Osteoarthritis Knee Score) (2008) Ann Rheum Dis, 67 (2), pp. 206-211; Hunter, D.J., Guermazi, A., Lo, G.H., Grainger, A.J., Conaghan, P.G., Boudreau, R.M., Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score) (2011) Osteoarthr Cartil, 19 (8), pp. 990-1002; Hunter, D.J., Zhang, Y.Q., Tu, X., Lavalley, M., Niu, J.B., Amin, S., Change in joint space width: hyaline articular cartilage loss or alteration in meniscus? (2006) Arthritis Rheum, 54 (8), pp. 2488-2495; Hunter, D.J., Zhang, Y.Q., Niu, J.B., Tu, X., Amin, S., Clancy, M., The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis (2006) Arthritis Rheum, 54 (3), pp. 795-801; Liu, Y., Joseph, G.B., Foreman, S.C., Li, X., Lane, N.E., Nevitt, M.C., Determining a threshold of medial meniscal extrusion for prediction of knee pain and cartilage damage progression over 4 years: data from the osteoarthritis initiative (2021) Am J Roentgenol, 216 (5), pp. 1318-1328; Xu, D., van der Voet, J., Waarsing, J.H., Oei, E.H., Klein, S., Englund, M., Are changes in meniscus volume and extrusion associated to knee osteoarthritis development? A structural equation model (2021) Osteoarthr Cartil, 29 (10), pp. 1426-1431; Wirth, W., Frobell, R.B., Souza, R.B., Li, X., Wyman, B.T., Hellio Le Graverand, M.-P., A three-dimensional quantitative method to measure meniscus shape, position, and signal intensity using MR Images: a pilot study and preliminary results in knee osteoarthritis (2010) Magn Reson Med, 63 (5); Wenger, A., Englund, M., Wirth, W., Hudelmaier, M., Kwoh, K., Eckstein, F., Relationship of 3D meniscal morphology and position with knee pain in subjects with knee osteoarthritis: a pilot study (2012) Eur Radiol, 22 (1), pp. 211-220; Gao, K.T., Xie, E., Chen, V., Iriondo, C., Calivà, F., Souza, R.B., Large-scale analysis of meniscus morphology as risk factor for knee osteoarthritis (2023) Arthritis Rheumatol; Sharma, K., Eckstein, F., Wirth, W., Emmanuel, K., Meniscus position and size in knees with versus without structural knee osteoarthritis progression: data from the osteoarthritis initiative (2022) Skeletal Radiol, 51 (5), pp. 997-1006; Ghouri, A., Robinson, E., Muzumdar, S., Barr, A., Murdoch, C., Kingsbury, S.R., A systematic review of the relationship between imaging-assessed meniscal pathologies, cartilage loss, joint replacement and pain in knee osteoarthritis (2022) Osteoarthr Cartil, 30 (10), pp. 1287-1327; Hunter, D.J., Nevitt, M., Losina, E., Kraus, V., Biomarkers for osteoarthritis: current position and steps towards further validation (2014) Best Pract Res Clin Rheumatol, 28 (1), pp. 61-71; Ornetti, P., Brandt, K., Hellio-Le Graverand, M.P., Hochberg, M., Hunter, D.J., Kloppenburg, M., OARSI-OMERACT definition of relevant radiological progression in hip/knee osteoarthritis (2009) Osteoarthr Cartil, 17 (7), pp. 856-863; Angst, F., Aeschlimann, A., Stucki, G., Smallest detectable and minimal clinically important differences of rehabilitation intervention with their implications for required sample sizes using WOMAC and SF-36 quality of life measurement instruments in patients with osteoarthritis of the lower ex (2001) Arthritis Rheum, 45 (4), pp. 384-391; Peterfy, C.G., Schneider, E., Nevitt, M., The osteoarthritis initiative: report on the design rationale for the magnetic resonance imaging protocol for the knee (2008) Osteoarthr Cartil, 16 (12), pp. 1433-1441; Schneider, E., NessAiver, M., White, D., Purdy, D., Martin, L., Fanella, L., The osteoarthritis initiative (OAI) magnetic resonance imaging quality assurance methods and results (2008) Osteoarthr Cartil, 16 (9), pp. 994-1004; Siorpaes, K., Wenger, A., Bloecker, K., Wirth, W., Hudelmaier, M., Eckstein, F., Interobserver reproducibility of quantitative meniscus analysis using coronal multiplanar DESS and IWTSE MR imaging (2012) Magn Reson Med, 67 (5), pp. 1419-1426; Kraus, V.B., Collins, J.E., Charles, H.C., Pieper, C.F., Whitley, L., Losina, E., Predictive validity of radiographic trabecular bone texture in knee osteoarthritis: the Osteoarthritis Research Society International/Foundation for the National Institutes of Health osteoarthritis biomarkers consortium (2018) Arthritis Rheumatol, 70 (1), pp. 80-87; Kraus, V.B., Collins, J.E., Hargrove, D., Losina, E., Nevitt, M., Katz, J.N., Predictive validity of biochemical biomarkers in knee osteoarthritis: data from the FNIH OA biomarkers consortium (2017) Ann Rheum Dis, 76 (1), pp. 186-195; Eckstein, F., Collins, J.E., Nevitt, M.C., Lynch, J.A., Kraus, V., Katz, J.N., Cartilage thickness change as an imaging biomarker of knee osteoarthritis progression - data from the fnih OA biomarkers consortium (2015) Arthritis Rheumatol; Hunter, D.J., Deveza, L.A., Collins, J.E., Losina, E., Nevitt, M.C., Roemer, F.W., Multivariable modeling of biomarker data from the phase 1 foundation for the NIH osteoarthritis biomarkers consortium (2022) Arthritis Care Res, 74 (7), pp. 1142-1153; Collins, J.E., Losina, E., Nevitt, M.C., Roemer, F.W., Guermazi, A., Lynch, J.A., Semi-quantitative imaging biomarkers of knee osteoarthritis progression: data from the FNIH OA biomarkers consortium (2016) Arthritis Rheumatol, 68 (10), pp. 2422-2431; Hunter, D., Nevitt, M., Lynch, J., Kraus, V.B., Katz, J.N., Collins, J.E., Longitudinal validation of periarticular bone area and 3D shape as biomarkers for knee OA progression? Data from the FNIH OA biomarkers consortium (2016) Ann Rheum Dis, 75 (9), pp. 1607-1614; Bloecker, K., Guermazi, A., Wirth, W., Benichou, O., Kwoh, C.K., Hunter, D.J., Tibial coverage, meniscus position, size and damage in knees discordant for joint space narrowing - data from the osteoarthritis initiative (2013) Osteoarthr Cartil, 21 (3); Okazaki, Y., Furumatsu, T., Yamaguchi, T., Kodama, Y., Kamatsuki, Y., Masuda, S., Medial meniscus posterior root tear causes swelling of the medial meniscus and expansion of the extruded meniscus: a comparative analysis between 2D and 3D MRI (2020) Knee Surg Sports Traumatol Arthrosc, 28 (11), pp. 3405-3415; Costa, C.R., Morrison, W.B., Carrino, J.A., Medial meniscus extrusion on knee MRI: Is extent associated with severity of degeneration or type of tear? (2004) Am J Roentgenol; Crema, M.D., Roemer, F.W., Felson, D.T., Englund, M., Wang, K., Jarraya, M., Factors associated with meniscal extrusion in knees with or at risk for osteoarthritis: the multicenter osteoarthritis study (2012) Radiology, 264 (2), pp. 494-503; Lee, D.H., Lee, B.S., Kim, J.M., Yang, K.S., Cha, E.J., Park, J.H., Predictors of degenerative medial meniscus extrusion: radial component and knee osteoarthritis (2011) Knee Surg Sports Traumatol Arthrosc, 19 (2), pp. 222-229; Roth, M., Wirth, W., Emmanuel, K., Culvenor, A.G., Eckstein, F., The contribution of 3D quantitative meniscal and cartilage measures to variation in normal radiographic joint space width—data from the osteoarthritis initiative healthy reference cohort (2017) Eur J Radiol, 87, pp. 90-98; Roth, M., Emmanuel, K., Wirth, W., Kwoh, C.K., Hunter, D.J., Eckstein, F., Sensitivity to change and association of three-dimensional meniscal measures with radiographic joint space width loss in rapid clinical progression of knee osteoarthritis (2018) Eur Radiol, 28, pp. 1844-1853; Roemer, F.W., Guermazi, A., Collins, J.E., Losina, E., Nevitt, M.C., Lynch, J.A., Semi-quantitative MRI biomarkers of knee osteoarthritis progression in the FNIH biomarkers consortium cohort − methodologic aspects and definition of change (2016) BMC Musculoskelet Disord, 17 (1), p. 466; Collins, J.E., Losina, E., Nevitt, M.C., Roemer, F.W., Guermazi, A., Lynch, J.A., Semiquantitative imaging biomarkers of knee osteoarthritis progression: data from the foundation for the National Institutes of Health osteoarthritis biomarkers consortium (2016) Arthritis Rheumatol, 68 (10), pp. 2422-2431

PY - 2023

Y1 - 2023

N2 - Objective: To study the association of quantitative medial meniscal position measures with radiographic and symptomatic knee osteoarthritis (OA) progression over 2–4 years. Methods: The FNIH OAI Biomarkers study comprised 600 participants in four subgroups: 194 case knees with combined structural (medial minimum joint space width (minJSW) loss ≥0.7 mm) and symptomatic (persistent Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale increase ≥9 [0–100 scale]) progression; 200 knees with neither structural nor symptomatic progression; 103 knees with isolated structural and 103 with isolated symptomatic progression. Coronal double echo at steady state (DESS) MRIs were used for segmenting five central slices of the medial meniscus. Associations with progression were examined using logistic regression (adjusted for demographic and clinical data). Results: Greater baseline medial meniscal extrusion was associated with combined structural/symptomatic progression (OR 1.59; 95%CI: [1.25,2.04]). No relationship was observed for tibial plateau coverage or meniscal overlap distance. The two-year increase in meniscal extrusion (OR 1.48 [1.21, 1.83]), and reduction in tibial plateau coverage (OR 0.70 [0.58,0.86]) and overlap distance (OR 0.73 [0.60,0.89]) were associated with combined progression. Greater baseline extrusion was associated with isolated structural and less extrusion with isolated symptomatic progression. The longitudinal increase in meniscal extrusion, and reduction in tibial plateau coverage and overlap distance were associated with structural, but not with symptomatic progression. Conclusion: Baseline measures of medial meniscal extrusion were consistently positively associated with combined radiographic/symptomatic progression and with isolated structural, but not with isolated symptomatic progression. These measures may therefore allow one to assess the risk of structural knee OA progression and to monitor interventions restoring meniscal position and function.

AB - Objective: To study the association of quantitative medial meniscal position measures with radiographic and symptomatic knee osteoarthritis (OA) progression over 2–4 years. Methods: The FNIH OAI Biomarkers study comprised 600 participants in four subgroups: 194 case knees with combined structural (medial minimum joint space width (minJSW) loss ≥0.7 mm) and symptomatic (persistent Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale increase ≥9 [0–100 scale]) progression; 200 knees with neither structural nor symptomatic progression; 103 knees with isolated structural and 103 with isolated symptomatic progression. Coronal double echo at steady state (DESS) MRIs were used for segmenting five central slices of the medial meniscus. Associations with progression were examined using logistic regression (adjusted for demographic and clinical data). Results: Greater baseline medial meniscal extrusion was associated with combined structural/symptomatic progression (OR 1.59; 95%CI: [1.25,2.04]). No relationship was observed for tibial plateau coverage or meniscal overlap distance. The two-year increase in meniscal extrusion (OR 1.48 [1.21, 1.83]), and reduction in tibial plateau coverage (OR 0.70 [0.58,0.86]) and overlap distance (OR 0.73 [0.60,0.89]) were associated with combined progression. Greater baseline extrusion was associated with isolated structural and less extrusion with isolated symptomatic progression. The longitudinal increase in meniscal extrusion, and reduction in tibial plateau coverage and overlap distance were associated with structural, but not with symptomatic progression. Conclusion: Baseline measures of medial meniscal extrusion were consistently positively associated with combined radiographic/symptomatic progression and with isolated structural, but not with isolated symptomatic progression. These measures may therefore allow one to assess the risk of structural knee OA progression and to monitor interventions restoring meniscal position and function.

KW - Knee

KW - Meniscus extrusion

KW - MRI

KW - Osteoarthritis

KW - Progression

KW - biological marker

KW - adult

KW - Article

KW - case control study

KW - clinical feature

KW - controlled study

KW - disease exacerbation

KW - female

KW - human

KW - knee osteoarthritis

KW - knee radiography

KW - major clinical study

KW - male

KW - medial meniscal extrusion

KW - middle aged

KW - musculoskeletal system parameters

KW - nuclear magnetic resonance imaging

KW - quantitative study

KW - risk factor

KW - Western Ontario and McMaster Universities Osteoarthritis Index

KW - diagnostic imaging

KW - knee

KW - knee meniscus

KW - tibia

KW - Disease Progression

KW - Humans

KW - Knee Joint

KW - Magnetic Resonance Imaging

KW - Menisci, Tibial

KW - Meniscus

KW - Osteoarthritis, Knee

KW - Tibia

UR - https://www.mendeley.com/catalogue/ccb723a1-ce1e-381f-9750-93d36df12e2c/

U2 - 10.1016/j.joca.2023.07.007

DO - 10.1016/j.joca.2023.07.007

M3 - Article

SN - 1063-4584

VL - 31

SP - 1396

EP - 1404

JO - Osteoarthritis Cartilage

JF - Osteoarthritis Cartilage

IS - 10

ER -

Association of quantitative measures of medial meniscal extrusion with structural and symptomatic knee osteoarthritis progression – Data from the OAI FNIH biomarker study

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