Meniscal damage associated with increased local subchondral bone mineral density: a Framingham study.

ABSTRACT

OBJECTIVE: Because menisci and the medial vs lateral tibial plateau bone mineral density ratio (ML BMD) are associated with loading within the knee, we postulated there to be an association between compartment-specific meniscal damage and ML BMD. We hypothesized that knees with higher ML BMD, consistent with increased medial subchondral BMD, would be associated with medial meniscal damage, and lower ratios with lateral meniscal damage. METHODS: We conducted a cross-sectional study evaluating participants in the Framingham Osteoarthritis Cohort having magnetic resonance images (MRIs), BMDs, and x-rays of the knee. Medial and lateral meniscal damage were defined on MRI. We performed a logistic regression with medial meniscal damage as the outcome testing ML BMD groups as predictor variables. We adjusted for age and sex; we used generalized estimating equations (GEE) to adjust for correlation between knees. Identical analyses were performed evaluating lateral meniscal damage. RESULTS: When evaluating the relation of ML BMD to medial meniscal damage, the odds ratios (ORs) of prevalent medial meniscal damage from lowest to highest quartile of ML BMD were 1.0 (referent), 1.9, 2.4 and 8.9, P for trend <0.0001. When evaluating the relation of ML BMD to lateral meniscal damage, the ORs of prevalent lateral meniscal damage from lowest to highest quartile of ML BMD were 1.0 (referent), 0.3, 0.2, and 0.2, P for trend = 0.001. CONCLUSIONS: Meniscal damage is associated with higher regional tibial BMD in the same compartment. Our findings highlight the close relationship between meniscal integrity and regional tibial subchondral BMD.