Factors associated with longitudinal change of meniscal extrusion in overweight women without clinical signs of osteoarthritis.

To identify variables associated with longitudinal change in meniscal extrusion, which might be used as possible targets for knee osteoarthritis (KOA) prevention.In a high-risk population of middle-aged overweight women, meniscal extrusion was assessed with magnetic resonance imaging (1.5 T, coronal proton density, in-plane resolution 0.5 mm2, Sante DICOM Editor) at baseline and after 30 months. Outcomes were the absolute change in medial and lateral extrusion (mm) and relative change in extrusion (%). Based upon literature, eleven factors were hypothesized to be associated with longitudinal change. Generalized estimating equations were used to model the effect on meniscal change (p< 0.05).677 knees of 343 women were available for analysis, with a mean age of 55.7 years (+/- 3.2) and a mean body mass index (BMI) of 32.3 kg/m2 (+/- 4.2). The greatest change in meniscal extrusion appeared medially with incident meniscal tear (4.4%; absolute 0.9 mm (95% CI: 0.3, 1.5; p= 0.004); relative 14.5% (4.4, 24.7; 0.005)). Varus malalignment was associated with an increase of medial extrusion of 0.6 mm (37.6%; 0.1, 1.0; 0.009)). A 5 kg/m2 higher baseline BMI was associated with absolute and relative increase of medial extrusion of 0.2 mm and 2.96% (0.1, 0.3; <0.001 and 1.3, 4.8; 0.002). Less explicit but significant changes in extrusion appeared with longitudinal change in BMI.Meniscal tears, varus malalignment and BMI were significantly associated with change in meniscal extrusion in middle-aged overweight women, providing viable therapeutic targets to prevent or reduce extrusion and thereby decelerate KOA development.

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Authors: Jan A van der Voet, Daan Wesselius, Fan Zhang, Dammis Vroegindeweij, Edwin H Oei, Sita M A Bierma-Zeinstra, Martin Englund, Jos Runhaar