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. 2024 Mar 25;12(3):23259671241237810.
doi: 10.1177/23259671241237810. eCollection 2024 Mar.

Changes in Functional Meniscal Morphology During Skeletal Growth and Maturation

Shankar G Kaushal  1 , Samuel C Barnett  1 , Shayan Hosseinzadeh  1 , Gabriel S Perrone  1   2 , Ata M Kiapour  1
Affiliations

Changes in Functional Meniscal Morphology During Skeletal Growth and Maturation

Shankar G Kaushal et al. Orthop J Sports Med. .

Abstract

Background: Little is known on how meniscal morphology develops during skeletal growth and maturation and its subsequent relationship with the corresponding bony anatomy.

Hypotheses: (1) Meniscal dimensions and morphology would change by age during skeletal growth and maturation in different ways in boys compared with girls. (2) Morphological features of the medial and lateral menisci would correlate to medial and lateral femoral condyle curvatures.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: Anatomic features of the medial and lateral menisci were measured on magnetic resonance imaging scans from 269 unique knees (age, 3-18 years; 51% female) with no prior history of injury, congenital or growth-related skeletal disorders, or bony deformities. Morphological shape-based measurements were normalized to tibial plateau width or determined as ratios of meniscal dimensions. The association between age and anatomy was analyzed with linear regression. Two-way analysis of variance with the Holm-Šídák post hoc method was used to compare anatomy between sexes in different age groups. Linear regression was used to evaluate the relationship between femoral condyle curvature radius and meniscal morphology in each compartment after adjusting for age and sex.

Results: Meniscal length, width, horn distance, mean cross-sectional area (CSA), and mean height increased with age in both sexes (R2 > 0.1; P < .001). Age-related changes in meniscal morphology were seen in normalized length, width, horn distance, and mean height; width-to-length ratio; horn distance-to-length ratio (lateral meniscus only); normalized mean CSA (except lateral meniscus in girls); and mean tip angle (R2 > 0.04; P < .02). Sex-based differences were also found, with some morphological differences (normalized length and height) throughout development (P < .03) and size differences (length, width, and mean CSA) in later development (P < .01). After adjusting for age and sex, there were significant correlations between medial condyle curvature radius and normalized width, width-to-length ratio, horn distance, horn distance-to-length ratio, mean CSA, and mean height of the medial meniscus (P≤ .041) and between lateral condyle curvature radius and normalized length, mean height, and mean tip angle of the lateral meniscus (P≤ .004).

Conclusion: Age-related changes in meniscal dimensions and morphology, most notably a nonuniform growth pattern in meniscal geometry, occurred during skeletal growth and maturation, with different trends in boys than in girls.

Keywords: anatomy; knee; meniscus; sex; skeletal maturation.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: Funding was received from the Children's Hospital Orthopaedic Surgery Foundation and Boston Children's Hospital Faculty Council. A.M.K. has received consulting fees from Miach Orthopaedics and maintained a conflict-of-interest management plan that was approved by Boston Children's Hospital and Harvard Medical School during the conduct of the study, with oversight by both conflict-of-interest committees and the institutional review board of Boston Children's Hospital. G.S.P. has received education payments from Kairos Surgical. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from Boston Children's Hospital (reference No. IRB-P00015233).

Figures

Figure 1.
Figure 1.
Measurement techniques used to quantify meniscal length (ML), meniscal width (MW), and meniscal horn distance (MHD); anterior and posterior meniscal cross-sectional area (ACSA and PCSA); anterior and posterior meniscal height (AMH and PMH) and anterior and posterior meniscal tip angle (α and β); femoral condyle curvature radius (FCR); and tibial plateau width (TPW). Separate measurements were performed for medial and lateral menisci.
Figure 2.
Figure 2.
Sex-based differences in medial (top row) and lateral (bottom row) menisci dimensions during skeletal growth and maturation. Results are presented as means with error bars representing 95% CIs. *Statistically significant difference (P < .05) between boys (blue) and girls (red). CSA, cross-sectional area.
Figure 3.
Figure 3.
Sex-based differences in medial meniscal morphology during skeletal growth and maturation. Results are presented as means with error bars representing 95% CIs. *Statistically significant difference (P < .05) between boys (blue) and girls (red). CSA, cross-sectional area.
Figure 4.
Figure 4.
Sex-based differences in lateral meniscal morphology during skeletal growth and maturations. Results are presented as means with error bars representing 95% CIs. *Statistically significant difference (P < .05) between boys (blue) and girls (red). CSA, cross-sectional area.
Figure 5.
Figure 5.
Changes in meniscal cross-sectional morphology of the medial and lateral menisci during skeletal growth and maturation. Left panel depicts cross section viewed, middle panel shows immature meniscal cross section, and right panel shows mature meniscal cross section.
See this image and copyright information in PMC

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