Reisner JH, Franco JM, Hollman JH, Johnson AC, Sellon JL, Finnoff JT. The Difference in Medial Meniscal Extrusion between Non-Weight-Bearing and Weight-Bearing Positions in People with and without Medial Compartment Knee Osteoarthritis.
PM R 2020;
13:470-478. [PMID:
32652849 DOI:
10.1002/pmrj.12450]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/23/2020] [Accepted: 06/30/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND
Medial meniscal extrusion (MME) has been correlated with medial meniscal injury and progression of medial knee osteoarthritis (OA).
OBJECTIVE
To examine the difference in MME between non-weight-bearing (supine) and weight-bearing (standing) positions in patients with and without medial knee OA. Determine the correlation between body mass index (BMI), Kellgren-Lawrence (KL) grade, Knee Osteoarthritis Outcome Score (KOOS), and MME.
DESIGN
Prospective.
SETTING
Tertiary institution PM&R Department.
PARTICIPANTS
Forty five participants (29 female, 16 male), 24 with healthy knees and 21 with OA.
METHODS OR INTERVENTIONS
A single physician sonographer measured supine and standing MME with ultrasound (US) on each participant. The physician was blinded to all measurements. BMI was recorded on all participants. KL grades and KOOS questionnaires were obtained for the OA group.
MAIN OUTCOME MEASURES
MME in supine and standing positions, change in MME from supine to standing, BMI, KL grade, and KOOS subscale scores.
RESULTS
MME increased .52 mm from supine to standing (P < .001). MME was greater in the OA group in both the supine (P = .002) and standing (P < .001) positions. Increasing BMI was moderately correlated with increasing MME (supine P = .001, standing <.001). Increasing age was correlated with increasing MME (supine P = .012, standing P = .002). Increasing KL grade (from 1 to 4) was correlated with increasing MME (supine P = .015, standing = .006). There was a small-to-moderate correlation between KOOS activities of daily living (ADL) subscale score and change in MME from supine to standing (P = .035). The change in MME from supine to standing positions had a small-to-moderate correlation (P = .035) with KOOS ADL subscale score alone but did not correlate with any of the other KOOS subscale scores or KOOS total scores. Receiver operating characteristic curve analysis suggested a standing MME value of 4.2 mm provides a positive likelihood ratio of 6.02 for knee OA.
CONCLUSIONS
MME is greater in those with OA and with weight-bearing. MME correlates with BMI, age, KL grade, and the KOOS ADL subscale score. Finally, standing MME of 4.2 mm yielded a higher positive likelihood ratio to differentiate between healthy knees and those with medial compartment OA than the previously reported value of 3.0 mm.
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