Are changes in meniscus volume and extrusion associated to knee osteoarthritis development? A structural equation model

D. Xu, J. van der Voet, J. H. Waarsing, E. H. Oei, S. Klein, M. Englund, F. Zhang, S. Bierma-Zeinstra, J. Runhaar*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)
38 Downloads (Pure)


Objective: To explore the interplay between (changes in) medial meniscus volume, meniscus extrusion and radiographic knee osteoarthritis (OA) development over 30 months follow-up (FU). Methods: Data from the PRevention of knee Osteoarthritis in Overweight Females study were used. This cohort included 407 middle-aged women with a body mass index ≥27 kg/m2, who were free of knee OA at baseline. Demographics were collected by questionnaires at baseline. All menisci at both baseline and FU were automatically segmented from MRI scans to obtain the meniscus volume and the change over time (delta volume). Baseline and FU meniscus body extrusion was quantitatively measured on mid-coronal proton density MR images. A structural equation model was created to assess the interplay between both medial meniscus volume and central extrusion at baseline, delta volume, delta extrusion, and incident radiographic knee OA at FU. Results: The structural equation modeling yielded a fair to good fit of the data. The direct effects of both medial meniscus volume and extrusion at baseline on incident OA were statistically significant (Estimate = 0.124, p = 0.029, and Estimate = 0.194, p < 0.001, respectively). Additional indirect effects on incident radiographic OA through delta meniscus volume or delta meniscus extrusion were not statistically significant. Conclusion: Baseline medial meniscus volume and extrusion were associated to incidence of radiographic knee OA at FU in middle-aged overweight and obese women, while their changes were not involved in these effects. To prevent knee OA, interventions might need to target the onset of meniscal pathologies rather than their progression.

Original languageEnglish
Pages (from-to)1426-1431
Number of pages6
JournalOsteoarthritis and Cartilage
Issue number10
Publication statusPublished - 1 Oct 2021

Bibliographical note

Funding Information:
This research was sponsored by the Netherlands Organisation for Health Research and Development (ZonMw 120520001 ), the China Scholarship Council (No. 201806380153 ) and the European Union's Horizon 2020 research and innovation programme under grant agreement No. 654248 , CORBEL – shared services for life-science.

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© 2021 The Authors


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