Objective

We conducted a systematic review in order to understand the relationship between imaging-visualised meniscus pathologies, hyaline cartilage, joint replacement and pain in knee osteoarthritis (OA).

Design

A search of the Medline, Excerpta Medica database (EMBASE) and Cochrane library databases was performed for original publications reporting association between imaging-detected meniscal pathology (extrusion or tear/damage) and longitudinal and cross-sectional assessments of hyaline articular cartilage loss [assessed on magnetic resonance imaging (MRI)], incident joint replacement and pain (longitudinal and cross-sectional) in knee OA. Each association was qualitatively characterised by a synthesis of data from each analysis, based upon study design and quality scoring (including risk of bias assessment and adequacy of covariate adjustment using Cochrane recommended methodology).

Results

In total 4,878 abstracts were screened and 82 publications were included (comprising 72 longitudinal analyses and 49 cross-sectional). Using high quality, well-adjusted data, meniscal extrusion and meniscal tear/damage were associated with longitudinal progression of cartilage loss, cross-sectional cartilage loss severity and joint replacement, independently of age, sex and body mass index (BMI). Medial and lateral meniscal tears were associated with cartilage loss when they occurred in the body and posterior horns, but not the anterior horns. There was a lack of high quality, well-adjusted meniscal pathology and pain publications and no clear independent association between meniscal extrusion or tear/damage with pain severity, progression in pain or incident frequent knee symptoms.

Conclusion

Meniscal features have strong associations with cartilage loss and joint replacement in knee OA, but weak associations with knee pain.

Systematic review PROSPERO registration number: CRD 42020210910

中文翻译：

---

膝骨关节炎中半月板病变、软骨损失、关节置换和疼痛之间的关系：系统评价

客观的

我们进行了系统评价，以了解成像可视化的半月板病理、透明软骨、关节置换和膝骨关节炎 (OA) 疼痛之间的关系。

设计

对 Medline、Excerpta Medica 数据库 (EMBASE) 和 Cochrane 图书馆数据库进行了搜索，以寻找原始出版物报告成像检测到的半月板病理学（挤压或撕裂/损伤）与透明关节软骨损失的纵向和横截面评估之间的关联 [评估关于磁共振成像（MRI）]，膝关节 OA 中的关节置换和疼痛（纵向和横截面）。根据研究设计和质量评分（包括偏倚风险评估和使用 Cochrane 推荐方法的协变量调整的充分性），每个分析的数据综合定性表征每个关联。

结果

总共筛选了 4,878 篇摘要，包括 82 篇出版物（包括 72 篇纵向分析和 49 篇横断面分析）。使用高质量、调整良好的数据，半月板挤压和半月板撕裂/损伤与软骨损失的纵向进展、横截面软骨损失严重程度和关节置换相关，与年龄、性别和体重指数 (BMI) 无关。内侧和外侧半月板撕裂发生在身体和后角时与软骨损失有关，但与前角无关。缺乏高质量、经过良好调整的半月板病理学和疼痛出版物，并且半月板挤压或撕裂/损伤与疼痛严重程度、疼痛进展或频繁发生的膝关节症状之间没有明确的独立关联。

结论

半月板特征与膝关节 OA 中的软骨损失和关节置换密切相关，但与膝关节疼痛的相关性较弱。

系统评价PROSPERO注册号：CRD 42020210910