Cross-sectional and longitudinal study of the impact of posterior meniscus horn lesions on adjacent cartilage composition, patient-reported outcomes and gait biomechanics in subjects without radiographic osteoarthritis

Abstract

Objective: The aim of this study was to assess cross-sectional and longitudinal effects of meniscal lesions on adjacent cartilage T_1ρ and T₂ relaxation times, patient-reported outcomes and gait biomechanics.

Design: Thirty patients with no cartilage morphological defects reported by Whole Organ MRI Score (WORMS) magnetic resonance imaging (MRI) grading and no radiographic osteoarthritis (OA) (Kellgren--Lawrence (KL) ≤ 1) were selected, 15 with posterior meniscus horn lesions and 15 matched controls without meniscal lesions. All were imaged on a 3T MR scanner for three consecutive years, except those who dropped from the study. Sagittal and frontal plane kinematic gait data were acquired at baseline. The Knee Injury and Osteoarthritis Outcome Score (KOOS) survey was taken each time. All images were automatically segmented and registered to an atlas for voxel-by-voxel cross-sectional and longitudinal analyses.

Results: Relaxation time comparisons between groups showed elevated T_1ρ of the lateral tibia (LP) and elevated T₂ of the medial tibia (MT) and LT at 1 and 2 years in the lesion group. Longitudinal comparisons within each group revealed greater relaxation time elevations over one and 2 years in the group with lesions. KOOS Quality of Life (QOL) was significantly different between the groups at all time points (P < 0.05), as were other KOOS subcategories. No significant differences in the frontal or sagittal biomechanics were observed between the groups at baseline.

Conclusions: Individuals with healthy cartilage and posterior meniscal horn lesions have increased relaxation times when compared to matched controls, increased relaxation time changes over 2 years, and consistently report a lower KOOS QOL, yet show no difference in gait biomechanics.

Keywords: Gait analysis; KOOS; Meniscus lesion; T(1ρ); T(2); Voxel-based relaxometry.

Fig. 1.

Diagramed are the overall study design and subject selection criteria for the 15 subjects with meniscus lesions and their matched controls.

Fig. 2.

In these 3D renderings, the average cartilage T_1ρ for each group (n = 15, 15) is overlaid onto a bone mesh constructed from the first echo in the two figures on the left. Voxel-based statistics, such as the average percent difference (second from the right) and average P-value (right) are also imaged. The arrows point to the region of significant difference between the groups in the LT.

Fig. 3.

In these 3D renderings, the average cartilage T_1ρ for each group is overlaid onto a bone mesh constructed from the first echo in the top four images. The arrow points to the longitudinal difference in the MFC, which is present in the group with meniscal lesions, but not in the group without.

Fig. 4.

In these 3D renderings, the average cartilage T₂ for each group is overlaid onto a bone mesh constructed from the first echo in the top four images. The arrow points to the longitudinal difference in the MT, which is present in the group with meniscal lesions, but not in the group without.