Arthritic Knees May Begin With Cartilage Loss
MONDAY, Feb. 27 (HealthDay News)
Damage to a pair of key knee structures called meniscus is associated with
advanced cartilage loss in early knee osteoarthritis, Boston researchers report.
Each knee is supported and protected by a pair of C-shaped meniscus that provide
load bearing and shock absorption functions, along with stability enhancement.
The onset of knee osteoarthritis is fairly common after surgical removal of
all or part of a torn meniscus (meniscectomy), but little is known about the
impact of meniscal damage and abnormalities on cartilage loss in knees of people
predisposed to osteoarthritis, noted researchers from Boston University School
This study included 257 people with knee osteoarthtritis who had MRI imaging
of their most severely affected knee at the start of the study, and then again
at 15 and 30 months into the study. The researchers used the MRI images to measure
the position of the meniscus and to evaluate the severity of meniscal damage.
Of the MRI-assessed knees, 29 percent had a previous injury, 27 percent had
a previous surgery, and 5 percent had a previous meniscectomy.
As expected, the researchers found a strong association between meniscal malposition
and meniscal damage. There was also a strong association between meniscal tears
and cartilage loss. In addition, the study found that reductions in coverage
and height of the meniscus -- caused by partial dislocation of the meniscus
-- increased the risk of cartilage loss. The findings appear in the March issue
of Arthritis & Rheumatism.
This study did not implicate meniscus damage as a cause of osteoarthritis
and did not distinguish the type of meniscal tear that may be linked to cartilage
loss. However, the researchers said the findings highlight the importance of
a strong, whole meniscus in protecting the knee from rapid damage in the early
stages of disease, and perhaps lessening the need for replacement surgery.
"At present, efforts are being made to preserve a damaged meniscus rather
than remove it, and an industry of meniscal replacement is developing,"
the authors wrote. "Our study points to the need for critical, prospective
evaluation of these new therapeutic options."
SOURCE: John Wiley & Sons Inc., news release, Feb. 27, 2006
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