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Radiographic OA, bone marrow lesions, higher body mass index and medial meniscal root tears are significantly associated with medial meniscus extrusion with OA or medial meniscal tears: a systematic review and meta-analysis

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Medial meniscus extrusion (MME) refers to the protrusion of the medial meniscus beyond the tibial edge by more than 3 mm, leading to a deficiency of the hoop strain. MME commonly occurs in conjunction with osteoarthritis (OA) or medial meniscal tears (MMT). However, factors associated with concomitant MME in patients with OA or MMT have not been systematically reviewed. This study aims to perform a systematic review and meta-analysis to identify factors associated with concomitant MME in OA or MMT.

Methods

The systematic review of the literature was performed according to PRISMA. A literature search was conducted in 4 databases. All original human studies that reported the available evidence on factors associated with concomitant MME in patients with OA or MMT were included. Pooled binary variables were analyzed by odds ratios (OR) and 95% CIs, and pooled continuous variables were evaluated by mean difference (MD) and 95% CIs.

Results

Ten studies on OA (5993 patients) and eight studies on MMT (872 patients) met the inclusion criteria. The overall pooled incidence of MME was 43% (95% CI, 37–50%) for OA, 61% (95% CI 43–77%) for MMT, and 85% (95% CI 72–94%) for medial meniscal root tears (MMRT). For the population with OA, Factors significantly associated with MME included radiographic OA [OR 4.24; 95% CI 3.07–5.84; P < 0.0001], bone marrow lesions [OR, 3.35; 95% CI 1.61–6.99; P = 0.0013], cartilage damage [OR, 3.25; 95% CI 1.60–6.61; P = 0.0011], and higher body mass index (BMI) [MD, 1.81; 95% CI 1.15–2.48; P < 0.0001]. Factors strongly associated with increased risk of MME for MMT included medial meniscal root [OR, 8.39; 95% CI 2.84–24.82; P < 0.0001] and radial tears [OR, 2.64; 95% CI 1.18–5.92; P < 0.0001].

Conclusion

Radiographic OA, bone marrow lesions, cartilage damage, and higher BMI were significantly associated with concomitant MME with OA. Furthermore, medial meniscal root and radial tears were significantly associated with an increased risk of MME in patients with MMT.

Level of evidence

IV.

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Data availability statement

The data sets produced or analyzed in this study can be obtained from the corresponding author upon reasonable request.

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Acknowledgements

The authors appreciate Prof. **hui Tian from the Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, for develo** the search strategy.

Funding

This study was funded by The National Natural Science Foundation of China (81874017, 81960403 and 82160422); Lanzhou Science and Technology Plan Program (2021-RC-102); Natural Science Foundation of Gansu Province (21JR7RA393 and 22JR5RA984); Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital (CY2021-MS-A07 and CY2020-BJ03).

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Authors and Affiliations

  1. Department of Orthopaedics, Orthopaedic Clinical Research Center of Gansu Province, Intelligent Orthopaedic Industry Technology Center of Gansu Province, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, 730000, Gansu, People’s Republic of China

    Hongwei Zhan, Zhongcheng Liu, Yaobin Wang, Yi Chen, Fei Teng, Ao Yang, Yuchen Tang, Yayi **a, Meng Wu & ** Jiang

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  1. Hongwei Zhan
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Contributions

ZHW conceived the project, the main conceptual ideas, and the proof sketch. ZHW, LZC and WYB wrote the manuscript, CY, TF, YA, and TYC extracted data and conducted the statistical analysis, and XYY, WM and JJ revised this manuscript. All authors discussed the results and contributed to the final manuscript.

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Correspondence to Yayi **a, Meng Wu or ** Jiang.

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Zhan, H., Liu, Z., Wang, Y. et al. Radiographic OA, bone marrow lesions, higher body mass index and medial meniscal root tears are significantly associated with medial meniscus extrusion with OA or medial meniscal tears: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 31, 3420–3433 (2023). https://doi.org/10.1007/s00167-023-07418-8

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