J Korean Orthop Assoc.  2018 Oct;53(5):429-434. 10.4055/jkoa.2018.53.5.429.

Meniscal Extrusions on a Non-Traumatic and Young Knee: Magnetic Resonance Imaging Study

Affiliations
  • 1Department of Orthopedic Surgery, Sahmyook Medical Center, Seoul, Korea. tsnam74@gmail.com

Abstract

PURPOSE
The aim of this study was to assess the size and extrusion of the meniscus in young and non-traumatic knees, especially in Korean males.
MATERIALS AND METHODS
The participants (n=91 knees, 77 patients) were consecutive patients observed at an orthopedic outpatient clinic who had another problem unrelated to the knee joint. The patients were excluded from the study if they had a history of trauma and pain on the knee joint. The patients received a magnetic resonance imaging (MRI) scan on the knee joint. The size, extrusion, and extrusion ratio of the meniscus on an MRI scan were evaluated.
RESULTS
The mean age of the participants was 21.6±1.1 years (range, 19-24 years). The mean size of the medial meniscus on the coronal plane was 9.0±1.1 mm (range, 7.1-11.9 mm). The extent of extrusion on the coronal plane was 2.0±1.0 mm (range, 0-4.4 mm). The extrusion ratio (extruded size/total size×100) of the medial meniscus on the coronal plane was 22.7%±11.5% (range, 0%-53.7%). The extent of extrusion on the sagittal plane was 1.6±1.1 mm (range, 0-4.0 mm). The extrusion ratio (extruded size/total×100) of the medial meniscus on the sagittal plane was 18.0%±11.9% (range, 0%-40.7%). The incidence of medial meniscal extrusion on the coronal and sagittal plane are 92.3% and 80.2%, respectively. The mean size of lateral meniscus on the coronal plane was 11.1±3.4 mm (range, 7.3-22.9 mm). The extent of extrusion on the sagittal plane was 0.5±0.7 mm (range, 0-2.5 mm). The extrusion ratio of the lateral meniscus on the sagittal plane was 4.0%±6.7% (range, 0%-26.3%). The incidence of lateral meniscal extrusion on the coronal plane was 34.1%. No extrusion of the lateral meniscus was observed on the sagittal plane.
CONCLUSION
In young and non-traumatic knees, the extrusion of meniscus was common, especially medial meniscus than lateral meniscus.

Keyword

meniscus; position; magnetic resonance imaging

MeSH Terms

Ambulatory Care Facilities
Humans
Incidence
Knee Joint
Knee*
Magnetic Resonance Imaging*
Male
Menisci, Tibial
Orthopedics

Figure

  • Figure 1 Extrusion was defined as the distance from the tibial plateau to the outer edge of the meniscus. Relative percentage of extrusion (RPE) was defined as (a) the absolute value of extruded meniscus divided by (b) the width of the whole meniscus (%).


Reference

1. DeHaven KE. The role of the meniscus. In : Ewing JW, editor. Articular cartilage and knee joint function: basic science and arthroscopy. New York: Raven Press, Ltd;1990. p. 103–115.
2. Bae JY, Park KS, Seon JK, Kwak DS, Jeon I, Song EK. Bio-mechanical analysis of the effects of medial meniscectomy on degenerative osteoarthritis. Med Biol Eng Comput. 2012; 50:53–60.
Article
3. Gale DR, Chaisson CE, Totterman SM, Schwartz RK, Gale ME, Felson D. Meniscal subluxation: association with osteoarthritis and joint space narrowing. Osteoarthr Cartil. 1999; 7:526–532.
Article
4. Sugita T, Kawamata T, Ohnuma M, Yoshizumi Y, Sato K. Radial displacement of the medial meniscus in varus osteoarthritis of the knee. Clin Orthop Relat Res. 2001; (387):171–177.
Article
5. Lee DH, Kim SB, Kim TH, Cha EJ, Bin SI. Midterm outcomes after meniscal allograft transplantation. Am J Sports Med. 2010; 38:247–254.
Article
6. Scott WN. Surgery of the knee. 4th ed. Churchill Livingstone: Elsevier;2006. p. 163.
7. Puig L, Monllau JC, Corrales M, Pelfort X, Melendo E, Cáceres E. Factors affecting meniscal extrusion: correlation with MRI, clinical, and arthroscopic findings. Knee Surg Sports Traumatol Arthrosc. 2006; 14:394–398.
Article
8. Adams JG, McAlindon T, Dimasi M, Carey J, Eustace S. Contribution of meniscal extrusion and cartilage loss to joint space narrowing in osteoarthritis. Clin Radiol. 1999; 54:502–506.
Article
9. Bennett LD, Buckland-Wright JC. Meniscal and articular cartilage changes in knee osteoarthritis: a cross-sectional double-contrast macroradiographic study. Rheumatology. 2002; 41:917–923.
Article
10. Crema MD, Roemer FW, Felson DT, et al. Factors associated with meniscal extrusion in knees with or at risk for osteoarthritis: the Multicenter Osteoarthritis study. Radiology. 2012; 264:494–503.
Article
11. Costa CR, Morrison WB, Carrino JA. Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? Am J Roentgenol. 2004; 183:17–23.
12. Ding C, Martel-Pelletier J, Pelletier JP, et al. Knee meniscal extrusion in a largely non-osteoarthritic cohort: association with greater loss of cartilage volume. Arthritis Res Ther. 2007; 9:R21.
Article
13. Englund M, Felson DT, Guermazi A, et al. Risk factors for medial meniscal pathology on knee MRI in older US adults: a multicentre prospective cohort study. Ann Rheum Dis. 2011; 70:1733–1739.
Article
14. Kijima H, Miyakoshi N, Kasukawa Y, et al. Cut-off values of medial meniscal extrusion for knee pain. Adv Orthop. 2017; 2017:6793026.
15. Miller TT, Staron RB, Feldman F, Cepel E. Meniscal position on routine MR imaging of the knee. Skeletal Radiol. 1997; 26:424–427.
Article
16. Kim JG, Han SW, Lee DH. Diagnosis and treatment of discoid meniscus. Knee Surg Relat Res. 2016; 28:255–262.
Article
17. Fukuta S, Masaki K, Korai F. Prevalence of abnormal findings in magnetic resonance images of asymptomatic knees. J Orthop Sci. 2002; 7:287–291.
Article
18. Kim SJ, Lee YT, Kim DW. Intraarticular anatomic variants associated with discoid meniscus in Koreans. Clin Orthop Relat Res. 1998; (356):202–207.
Article
19. Rao PS, Rao SK, Paul R. Clinical, radiologic, and arthroscopic assessment of discoid lateral meniscus. Arthroscopy. 2001; 17:275–277.
Article
Full Text Links
  • JKOA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr