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High frequency of meniscal hypertrophy in persons with advanced varus knee osteoarthritis
Rheumatology International, 10/20/09

Jung KA et al. – A large proportion of persons with end stage varus knee OA have a paradoxically hypertrophied medial meniscus. This new finding of hypertrophied menisci highlights that not all menisci in persons with end stage OA are macerated or destroyed

Methods

167 knee joints of 106 patients who subsequently underwent total knee joint arthroplasty from January to May, 2007 included
All 106 patients were females and ages ranged from 57 to 83 years
For patients with complete loss of medial joint space by weight-bearing radiography, meniscal position assessed by measuring meniscal subluxation and meniscal height
Meniscal morphology assessed using modified WORMS MRI-based method

Results

Predominant type (32.2, 64.1 and 83.8% in anterior horn, mid-body and posterior horn, respectively) of meniscal morphology abnormality was hypertrophied displaced tear
Medial meniscus height found to be higher than lateral meniscus height
In hypertrophied meniscus the height of medial meniscus was 8.06 ± 1.15, 10.03 ± 1.79, and 8.61 ± 1.57 mm at anterior horn, mid-body and posterior horn, respectively, compared to those in other categories whose height was 6.04 ± 0.92, 5.08 ± 1.68 and 6.43 ± 1.26 mm pro

Exclusive Author Commentary
David Hunter, 10/20/09

The medial meniscus is paradoxically hypertrophied in a large proportion of persons with advanced knee OA. The hypertrophied meniscus with increased meniscal height was the predominant form of meniscal abnormality identified in our sample. Therefore, we consider that the existing knee osteoarthritis evaluation methods require modification with respect to determining meniscal morphology scores to include the hypertrophied meniscus. To our knowledge this is the first description of the prevalence of different meniscal morphologies in persons with end stage OA and the high prevalence of hypertrophied displaced tears of the meniscus. This is an intriguing and paradoxical result since in such advanced OA, it has been postulated that medial meniscus is either destroyed or macerated.

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