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Assessment of meniscal extrusion with ultrasonography: a systematic review and meta‑analysis

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Background: Magnetic Resonance Imaging (MRI) is the imaging of choice for meniscal extrusion (ME). However, they may underappreciate the load-dependent changes of the meniscus. There is growing evidence that weight-bearing ultrasound (WB US) is more suitable, particularly in revealing occult extrusion. We therefore perform a systematic review and meta-analysis on the validity and reliability of US in diagnosing extrusion. Furthermore, we explored whether it detects differences in extrusion between loaded and unloaded positions and those with pathological (osteoarthritis and meniscal injury) and healthy knees. Methods: The Cochrane Controlled Register of Trials, PubMed, Medline and Embase were used to perform a systematic review using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria. Data pertaining to intra- and inter-rater reliability of US in measuring Meniscal extrusion (ME), its correlation with Magnetic Resonance Imaging (MRI), and head-to-head comparison of potential factors to influence ME were included (loading vs. unloading position; osteoarthritis (OA) or pathological menisci (PM) vs healthy knees; mild vs moderate-severe knee OA). Pooled data were analysed by random or fixed-effects models. Results: 31 studies were included. Intra-class correlation coefficients (ICC) for intra- and inter-rater reliability were minimum 0.94 and 0.91 respectively. The correlation between US and MRI was (r = 0.76). US detected ME to be greater in the loaded position in all knees (healthy, p < 0.00001; OA, p < 0.00001; PM, p = 0.02). In all positions, US detected greater extrusion in OA (p < 0.0003) and PM knees (p = 0.006) compared to healthy controls. Furthermore, US revealed greater extrusion in moderate-severe OA knees (p < 0.00001). Conclusion: This systematic review suggests ultrasonography can play an important role in the measurement of meniscal extrusion, with results comparable to that of MRI. However, to what extent it can differentiate between physiological and pathological extrusion requires further investigation, with an absolute cut-off value yet to be determined. Nevertheless, it is an appropriate investigation to track the progression of disease in those with meniscal pathologies or osteoarthritis. Furthermore, it is a feasible investigation to evaluate the meniscal function following surgery.

Abstract

Background: Magnetic Resonance Imaging (MRI) is the imaging of choice for meniscal extrusion (ME). However, they may underappreciate the load-dependent changes of the meniscus. There is growing evidence that weight-bearing ultrasound (WB US) is more suitable, particularly in revealing occult extrusion. We therefore perform a systematic review and meta-analysis on the validity and reliability of US in diagnosing extrusion. Furthermore, we explored whether it detects differences in extrusion between loaded and unloaded positions and those with pathological (osteoarthritis and meniscal injury) and healthy knees. Methods: The Cochrane Controlled Register of Trials, PubMed, Medline and Embase were used to perform a systematic review using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria. Data pertaining to intra- and inter-rater reliability of US in measuring Meniscal extrusion (ME), its correlation with Magnetic Resonance Imaging (MRI), and head-to-head comparison of potential factors to influence ME were included (loading vs. unloading position; osteoarthritis (OA) or pathological menisci (PM) vs healthy knees; mild vs moderate-severe knee OA). Pooled data were analysed by random or fixed-effects models. Results: 31 studies were included. Intra-class correlation coefficients (ICC) for intra- and inter-rater reliability were minimum 0.94 and 0.91 respectively. The correlation between US and MRI was (r = 0.76). US detected ME to be greater in the loaded position in all knees (healthy, p < 0.00001; OA, p < 0.00001; PM, p = 0.02). In all positions, US detected greater extrusion in OA (p < 0.0003) and PM knees (p = 0.006) compared to healthy controls. Furthermore, US revealed greater extrusion in moderate-severe OA knees (p < 0.00001). Conclusion: This systematic review suggests ultrasonography can play an important role in the measurement of meniscal extrusion, with results comparable to that of MRI. However, to what extent it can differentiate between physiological and pathological extrusion requires further investigation, with an absolute cut-off value yet to be determined. Nevertheless, it is an appropriate investigation to track the progression of disease in those with meniscal pathologies or osteoarthritis. Furthermore, it is a feasible investigation to evaluate the meniscal function following surgery.

참고문헌 (75)

  1. Costa CR, "Medial meniscus extrusion on knee MRI : is extent associated with severity of degeneration or type of tear?", AJR, 183, pp.17~23 (2004)[DOI]
  2. Crema MD, "Factors associated with meniscal extrusion in knees with or at risk for osteoarthritis : the Multicenter Osteoarthritis study", Radiology, 264, pp.494~503 (2012)[DOI]
  3. Lerer DB, "The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion", Skeletal Radiol, 33, pp.569~574 (2004)[DOI]
  4. Roemer FW, "Tibiofemoral joint osteoarthritis : risk factors for MR-depicted fast cartilage loss over a 30-month period in the multicenter osteoarthritis study", Radiology, 252, pp.772~780 (2009)[DOI]
  5. Madan-Sharma R, "Do MRI features at baseline predict radiographic joint space narrowing in the medial compartment of the osteoarthritic knee 2 years later?", Skeletal Radiol, 37, pp.805~811 (2008)[DOI]
  6. Berthiaume MJ, "Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging", Ann Rheum Dis, 64, pp.556~563 (2005)[DOI]
  7. Gale DR, "Meniscal subluxation : association with osteoarthritis and joint space narrowing", Osteoarthr Cartil, 7, pp.526~532 (1999)[DOI]
  8. Ko C-H, "Sonographic imaging of meniscal subluxation in patients with radiographic knee osteoarthritis", J Formos Med Assoc, 106, pp.700~707 (2007)[DOI]
  9. Adams JG, "Contribution of meniscal extrusion and cartilage loss to joint space narrowing in osteoarthritis", Clin Radiol, 54, pp.502~506 (1999)[DOI]
  10. Ding C, "Knee meniscal extrusion in a largely non-osteoarthritic cohort : association with greater loss of cartilage volume", Arthritis Res Ther, 9, pp.R21~ (2007)[DOI]
  11. Klein JS, "Baseline cartilage thickness and meniscus extrusion predict longitudinal cartilage loss by quantitative MRI : data from the Osteoarthritis Initiative", J Comput Assist Tomogr, 40, pp.979~984 (2016)[DOI]
  12. Zhang F, "Risk factors for meniscal body extrusion on MRI in subjects free of radiographic knee osteoarthritis : longitudinal data from the Osteoarthritis Initiative", Osteoathritis Cartilage, 24, pp.801~806 (2016)[DOI]
  13. Brody JM, "Lateral meniscus root tear and meniscus extrusion with anterior cruciate ligament tear", Radiology, 239, pp.805~810 (2006)[DOI]
  14. Friedman L, "Ultrasound of the knee", Skeletal Radiol, 30, pp.361~377 (2001)[DOI]
  15. Lee D, "Ultrasound of the knee", Eur J Ultrasound, 14, pp.57~71 (2001)[DOI]
  16. D’Agostino MA, "Ultrasonography in inflammatory joint disease : why should rheumatologists pay attention?", Joint Bone Spine, 69, pp.252~255 (2002)[DOI]
  17. Grassi W, "Ultrasonography in rheumatology : an evolving technique", Ann Rheum Dis, 57, pp.268~271 (1998)[DOI]
  18. Farivar D, "Measuring technique for meniscal extrusion using ultrasound in the setting of posterior medial meniscal root tears", Arthrosc Tech, 13, pp.102916~ (2024)[DOI]
  19. Kawaguchi K, "Ultrasonographic evaluation of medial radial displacement of the medial meniscus in knee osteoarthritis", Arthritis Rheum, 64, pp.173~180 (2012)[DOI]
  20. Verdonk P, "Normal and transplanted lateral knee menisci : evaluation of extrusion using magnetic resonance imaging and ultrasound", Knee Surg Sports Traumatol Arthrosc, 12, pp.411~419 (2004)[DOI]
  21. Casser HR, "Current evaluation of sonography of the meniscus. Results of a comparative study of sonographic and arthroscopic findings", Arch Orthop Trauma Surg, 109, pp.150~154 (1990)[DOI]
  22. Najafi J, "The value of sonography with micro convex probes in diagnosing meniscal tears compared with arthroscopy", J Ultrasound Med, 25, pp.593~597 (2006)[DOI]
  23. Liberati A, "The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions : explanation and elaboration", J Clin Epidemiol, 6, pp.e1000100~ (2009)[DOI]
  24. Coleman BD, "Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies", Scand J Med Sci Sports, 10, pp.2~11 (2000), Victorian Institute of Sport Tendon Study Group[DOI]
  25. Boksh K, "Fibular versus tibiofibular-based reconstruction of the posterolateral corner of the knee : a systematic review and meta-analysis", Am J Sports Med, 51, pp.3880~3892 (2023)[DOI]
  26. Boksh K, "The role of anterolateral ligament reconstruction or lateral extra-articular tenodesis for revision anterior cruciate ligament reconstruction : a systematic review and meta-analysis of comparative clinical studies", Am J Sports Med, 52, pp.269~285 (2024)[DOI]
  27. Sterne JA, "ROBINS-I : a tool for assessing risk of bias in non-randomised studies of interventions", BMJ, 355, pp.4~10 (2016)[DOI]
  28. Acebes C, "Dynamic ultrasound assessment of medial meniscal subluxation in knee osteoarthritis", Rheumatology, 52, pp.1443~1447 (2013)[DOI]
  29. Achtnich A, "Medial meniscus extrusion increases with age and BMI and is depending on different loading conditions", Knee Surg Sports Traumatol Arthrosc, 26, pp.2282~2288 (2018)[DOI]
  30. Cho JC, "Sonographic evaluation of the degree of medial meniscal extrusion during Thessaly test in healthy knees", Chriopr Man Therap, 29, pp.31~ (2021)[DOI]
  31. Chiba D, "Meniscal extrusion seen on ultrasonography affects the development of radiographic knee osteoarthritis : a 3-year prospective cohort study", Clin Rheumatol, 36, pp.2557~2564 (2017)[DOI]
  32. Diermeier T, "Mountain ultramarathon results in temporary meniscus extrusion in healthy athletes", Knee Surg Sports Traumatol Arthrosc, 27, pp.2691~2697 (2019)[DOI]
  33. Elkwesny GMM, "Role of musculoskeletal ultrasound in assessment of extrusion of the medial meniscus of the knee joint compared to MRI as a reference standard", Sys Rev Pharm, 11, pp.534~540 (2020)
  34. Falkowski AL, "Medial meniscal extrusion evaluation with weight-bearing ultrasound correlation with MR imaging findings and reported symptoms", J Ultrasoun Med, 41, pp.2867~2875 (2022)[DOI]
  35. Iagnocco A, "The interobserver reliability of ultrasound in knee osteoarthritis", Rheumatology, 51, pp.2013~2019 (2012)[DOI]
  36. Ishii Y, "Effects of lateral wedge insole application on medial compartment knee osteoarthritis severity evaluated by ultrasound", Knee, 24, pp.1408~1413 (2017)[DOI]
  37. Ishii Y, "Increase in medial meniscal extrusion in the weight-bearing position observed on ultrasonography correlates with lateral thrust in early stage knee osteoarthritis", J Orthop Sci, 25, pp.640~646 (2020)[DOI]
  38. Ishii Y, "Dynamic ultrasound reveals the specific behavior of the medial meniscus extrusion in patients with knee osteoarthritis", BMC Musculoskelet Disord, 24, pp.272~ (2023)[DOI]
  39. Ishii Y, "Dynamic ultrasonography of the medial meniscus during walking in knee osteoarthritis", Knee, 27, pp.1256~1262 (2020)[DOI]
  40. Karpinski K, "No dynamic extrusion of the medial meniscus in ultrasound examination in patients with confirmed root tear lesion", Knee Surg Sports Traumatol Arthrosc, 27, pp.3311~3317 (2019)[DOI]
  41. Murakami T, "Useful ultrasonographic evaluation of the medial meniscus as a feature predicting the onset of radiographic knee osteoarthritis", J Orthop Sci, 22, pp.318~324 (2017)[DOI]
  42. Nogueira-Barbosa MH, "Ultrasound assessment of medial meniscal extrusion : a validation study using MRI as reference standard", AJR Am J Roentgenol, 204, pp.584~588 (2015)[DOI]
  43. Oo WM, "Reliability and convergent construct validity of quantitative ultrasound for synovitis, meniscal extrusion, and osteophyte in knee osteoarthritis with MRI", J Ultrasound Med, 41, pp.1559~1573 (2022)[DOI]
  44. Ozdemir M, "Correlation between medial meniscal extrusion determined by dynamic ultrasound and magnetic resonance imaging findings of medial-type knee osteoarthritis in patients with knee pain", J Ultrasound Med, 38, pp.2709~2719 (2019)[DOI]
  45. Podlipska J, "Comparison of diagnostic performance of semi-quantitative knee ultrasound and knee radiography with MRI : Oulu knee osteoarthritis study", Sci Rep, 6, pp.22365~ (2016)[DOI]
  46. Razek AAKA, "Ultrasound of knee osteoarthritis : interobserver agreement and correlation with Western Ontario and McMaster Universities Osteoarthritis", Clin Rheumatol, 35, pp.997~1001 (2016)[DOI]
  47. Reisner JH, "Ultrasound assessment of weight-bearing and non-weight-bearing meniscal extrusion : a reliability study", PM R, 12, pp.26~35 (2020)[DOI]
  48. Reisner JH, "The difference in medial meniscal extrusion between non-weight-bearing and weight-bearing positions in people with and without medial compartment knee osteoarthritis", PM R, 13, pp.470~478 (2021)[DOI]
  49. Shimozaki K, "Usefulness of ultrasonography for dynamic evaluation of medial meniscus hoop function in early knee osteoarthritis", Sci Rep, 11, pp.20091~ (2021)[DOI]
  50. Shimozaki K, "Investigation of extrusion of the medial meniscus under full weightloading conditions using upright weight-loading magnetic resonance imaging and ultrasonography", J Orthop Sci, 25, pp.652~657 (2020)[DOI]
  51. Winkler P, "Sonographic evaluation of lateral meniscal extrusion : implementation and validation", Arch Orthop Trauma Surg, 141, pp.271~281 (2021)[DOI]
  52. Yanagisawa S, "Sonographic evaluation of the medial aspect of the knee in a population-based cohort study", J Clin Ultrasoun, 43, pp.318~321 (2015)[DOI]
  53. Yanagisawa S, "Morphological evaluation and diagnosis of medial type osteoarthritis of the knee using ultrasound", J Orthop Sci, 19, pp.270~274 (2014)[DOI]
  54. Yanagisawa S, "Population-based study of the relationship between medial meniscus radial displacement, determined by use of ultrasound screening, and knee pain", J Orthop Sci, 19, pp.854~958 (2014)[DOI]
  55. Zeitoun R, "Assessment of medial meniscus extrusion as an indirect sign of tear on ultrasound with emphasis on the added value of standing position", Kasr Al Ainy Med J (2021)[DOI]
  56. Koo TK, "A guideline of selecting and reporting intraclass correlation coefficients for reliability research", J Chiropr Med, 15, pp.155~163 (2016)[DOI]
  57. Evans JD, "Straightforward statistics for the behavioral sciences", pp.1996, Brooks
  58. Patel R, "Loaded versus unloaded magnetic resonance imaging(MRI)of the knee : effect on meniscus extrusion in healthy volunteers and patients with osteoarthritis", Eur J Radiol Open, 3, pp.100~107 (2006)[DOI]
  59. Rowland G, "Evaluation of meniscal extrusion with posterior root disruption and repair using ultrasound", Knee, 23, pp.627~630 (2016)[DOI]
  60. Petersen W, "Collagenous fibril texture of the human knee joint menisci", Anat Embryol(Berl), 197, pp.317~324 (1998)[DOI]
  61. Boxheimer L, "MR imaging of the knee : position related changes of the menisci in asymptomatic volunteers", Invest Radiol, 39, pp.254~263 (2004)[DOI]
  62. Puig L, "Factors affecting meniscal extrusion : correlation with MRI, clinical, and arthroscopic findings", Knee Surg Sports Traumatol Arthrosc, 14, pp.394~ (2006)[DOI]
  63. Hajek PC, "The high signal intensity meniscus of the knee. Magnetic resonance evaluation and in vivo correlation", Invest Radiol, 22, pp.883~890 (1987)[DOI]
  64. Roos H, "Knee osteoarthritis after meniscectomy : prevalence of radiographic changes after twenty-one years, compared with matched controls", Arthritis Rheum, 41, pp.687~693 (1998)[DOI]
  65. Hunter DJ, "The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis", Arthritis Rheum, 54, pp.795~801 (2006)[DOI]
  66. Verdonk PC, "Transplantation of viable meniscal allograft : survivorship analysis and clinical outcome of one hundred cases", J Bone Jt Surg Am, 87, pp.715~724 (2005)[DOI]
  67. van Arkel ER, "Meniscal allografts : evaluation with magnetic resonance imaging and correlation with arthroscopy", Arthroscopy, 16, pp.517~521 (2000)[DOI]
  68. Shrout PE, "Intraclass correlations : uses in assessing rater reliability", Psychol Bull, 86, pp.420~428 (1979)[DOI]
  69. Walter SD, "Sample size and optimal designs for reliability studies", Stat Med, 17, pp.101~110 (1998)[DOI]
  70. Pomeranz SJ, "Gamuts and pearls in MRI" (1993), MRI & EFI Publications
  71. Breitenseher MJ, "MR imaging of meniscal subluxation in the knee", Acta Radiol, 38, pp.876~879 (1997)[DOI]
  72. Berlet GC, "The anterior horn of the medical meniscus. An anatomic study of its insertion", Am J Sports Med, 26, pp.540~543 (1998)[DOI]
  73. Yao J, "Magnetic resonance image analysis of meniscal translation and tibio-menisco-femoral contact in deep knee flexion", J Orthop Res, 26, pp.673~684 (2008)[DOI]
  74. Daskiewicz K, "Biomechanical of the medial meniscus in the osteoarthritic knee joint", Peer J, 9, pp.e12509~ (2021)[DOI]
  75. Morrison JB, "The mechanics of the knee joint in relation to normal walking", J Biomech, 3, pp.51~61 (1970)[DOI]

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