Meniscal anterior and posterior horn heights are associated with MRI-defined knee structural abnormalities in middle-aged and elderly patients with symptomatic knee osteoarthritis

Abstract

Background: Meniscal morphological changes are associated with knee OA. However, the correlation of meniscal height and OA-related knee structural abnormalities is still not well understood. The purpose of present study is to investigate whether and how meniscal anterior and posterior horn heights are associated with structural abnormalities in knees with symptomatic OA.

Methods: Our sample consisted of 106 patients (61 female, aged 40-73 years) with symptomatic knee OA. Kellgren-Lawrence system was used for radiographic evaluation. On sagittal sequence, medial meniscal posterior horn height (MPH), lateral meniscal anterior horn height (LAH) and lateral meniscal posterior horn height (LPH) were measured on the middle slice through the medial/lateral compartment. Knee structural abnormalities were assessed using the modified whole-organ magnetic resonance imaging score (WORMS). Associations between meniscal anterior and posterior horn heights and knee structural abnormalities were assessed using linear regression analysis.

Results: Higher MPH was significantly associated with higher WORMS score for medial meniscal anterior horn lesion (P = 0.016) but did not have a statistical association with other WORMS parameters. Increased LAH was statistically correlated with decreased WORMS scores for lateral compartmental cartilage lesions (P = 0.001-0.004) and lateral compartmental bone marrow edema patterns (BMEPs) (P = 0.021-0.027). Moreover, LPH was negatively associated with WORMS scores for lateral compartmental cartilage lesions (P = 0.007-0.041) and lateral compartmental BMEPs (P = 0.022-0.044). Additionally, higher MPH was statistically associated with lower trochlea cartilage WORMS score and higher LAH was significantly correlated with higher WORMS score for trochlea subarticular cysts.

Conclusions: Changes of LAH and LPH were inversely associated with the severity of lateral compartmental cartilage lesions and BMEPs, while higher MPH was only significantly correlated with more severe medial meniscal anterior horn lesions. Besides, MPH and LAH were also significantly associated with patellofemoral structural abnormalities. The present study provided novel information for understanding the role of meniscal morphological changes in knee OA, which would be helpful in identifying and evaluating knees with or at risks for OA.

Keywords: Knee; Meniscal height; Osteoarthritis.