Meniscal degeneration among knees without radiographic osteoarthritis correlates with changes in disease activity and subsequent cumulative damage: Data from the Osteoarthritis Initiative

Abstract

Objective

To explore the relationship between meniscal degeneration (intrameniscal signal alteration without a tear) and future osteoarthritis pathology as measured by composite scores based on magnetic resonance imaging (MRI) of disease activity (bone marrow lesions and effusion-synovitis volumes) and cumulative damage (articular cartilage damage).

Design

This analysis involved 225 participants from the Osteoarthritis Initiative with intact menisci (defined as normal or meniscal degeneration without tear) on MRI and no radiographic knee osteoarthritis at baseline. We used longitudinal MRIs from an existing study to calculate disease activity and cumulative damage. We used robust regression models to assess the association between baseline meniscal degeneration (exposure) and disease activity or cumulative damage at baseline and four annual follow-up visits (outcomes), adjusting for sex, race, age, static alignment, and body mass index.

Results

Our sample included 110 participants with normal menisci (77 % women, average age 55 [SD 7]) and 115 with meniscal degeneration (60 % women, average age 61 [SD 9]). Knees with meniscal degeneration were more likely to have, on average, 0.21 greater disease activity at 12 months than knees with normal menisci (parameter estimate = 0.21, 95 % confidence interval (CI) = 0.09, 0.33). The association persisted over time. In contrast, the association between meniscal degeneration and cumulative damage only became statistically significant at the 48-month visit (parameter estimate = 0.74, 95 % CI = 0.18, 1.31).

Conclusions

Meniscal degeneration was related to worsening disease activity earlier than articular cartilage damage among knees without radiographic osteoarthritis. Meniscal degeneration and disease activity are promising biomarkers for early detection and monitoring of osteoarthritis, and may inform potential early intervention strategies.