nach oben

Erschienen in:

08.08.2023 | Original Paper

Could a three-dimensional contralateral meniscus segmentation for allograft or scaffold sizing be possible? A prospective study

verfasst von: Valcarenghi Jérôme, Hernigou Jacques, Chahidi Esfandiar, Collard Xavier, Francotte Dorothée, Jennart Harold, Verdonk René

Erschienen in: International Orthopaedics | Ausgabe 10/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Meniscal allografts and biodegradable meniscal implants are attractive surgical options for painful subtotal or total meniscectomies. In order to get the best results, these should be as similar as possible to the original meniscus in terms of shape, structure, and volume. Three-dimensional meniscus sizing could be an approach to improve the accuracy of meniscus matching. Therefore, the aims of this study were to perform a comparative morphological and volumetric analysis of the healthy meniscus based on manual tri-planar segmentation and to demonstrate that the menisci from the contralateral knee could be used as a reference in the sizing of a meniscal graft or a scaffold.

Methods

Three-dimensional meniscal models were created based on 120 MRIs in 60 healthy subjects (bilateral knees). The differences between the pairs of menisci concerning the widths, thicknesses, lateromedial distances, anteroposterior distances, angles of coverage, and meniscal volumes were evaluated. T-Student tests were used to compare the quantitative numerical variables of the different groups. Pearson’s linear regression was used to determine if correlations existed between demographic variables (age, gender, height, weight) and anatomical parameters. Statistical significance was set at p < 0.05.

Results

Comparing the 120 pairs of menisci of each subject, there was no statistically significant difference for all parameters studied for both the medial and lateral meniscus. When the measurements were stratified by gender, statistically significant differences were observed for all parameters except meniscal coverage angles. We observed that anteroposterior and lateromedial distances were positively correlated with height and body mass index both at the level of the medial meniscus (r = 0.68; r = 0.66; r = 0.65; and r = 0.63) and lateral (r = 0.68; r = 0.69; r = 0.61; and r = 0.60).

Conclusion

Our study demonstrated that the intra-individual 3D shapes of the left and right menisci are very similar. Therefore, the contralateral side could be used as a template for the 3D sizing of meniscal allografts or meniscal implants.

Toanen C, Dhollander A, Bulgheroni P et al (2020) Polyurethane meniscal scaffold for the treatment of partial meniscal deficiency: 5-year follow-up outcomes: a European multicentric study. Am J Sports Med 48:1347–1355. https://doi.org/10.1177/0363546520913528CrossRefPubMed

Beaufils P, Becker R, Kopf S et al (2017) Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc 25:335–346. https://doi.org/10.1007/s00167-016-4407-4CrossRefPubMedPubMedCentral

Kopf S, Beaufils P, Hirschmann MT et al (2020) Management of traumatic meniscus tears: the 2019 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc 28:1177–1194. https://doi.org/10.1007/s00167-020-05847-3CrossRefPubMedPubMedCentral

Pujol N, Beaufils P (2019) Save the meniscus again! Knee Surg Sports Traumatol Arthrosc 27:341–342. https://doi.org/10.1007/s00167-018-5325-4CrossRefPubMed

Espejo-Reina A, Aguilera J, Espejo-Reina MJ et al (2019) One-third of meniscal tears are repairable: an epidemiological study evaluating meniscal tear patterns in stable and unstable knees. Arthrosc J Arthrosc Relat Surg 35:857–863. https://doi.org/10.1016/j.arthro.2018.08.051CrossRef

Kamatsuki Y, Furumatsu T, Hiranaka T et al (2023) Epidemiological features of acute medial meniscus posterior root tears. Int Orthop. https://doi.org/10.1007/s00264-023-05848-0

Lucidi GA, Grassi A, BbH A-z’b et al (2021) Satisfactory clinical results and low failure rate of medial collagen meniscus implant (CMI) at a minimum 20 years of follow-up. Knee Surg Sports Traumatol Arthrosc 29:4270–4277. https://doi.org/10.1007/s00167-021-06556-1CrossRefPubMedPubMedCentral

Barlow T, Coco V, Shivji F et al (2022) Patient-reported outcome and survival following meniscal allograft transplantation: an international case series. Bone Jt J 104:657–662. https://doi.org/10.1302/0301-620X.104B6.BJJ-2021-0944.R2CrossRef

Bakowski P, Mieloch AA, Porzucek F et al (2023) Meniscus repair via collagen matrix wrapping and bone marrow injection: clinical and biomolecular study. Int Orthop. https://doi.org/10.1007/s00264-023-05711-2

10.

Zaffagnini S, Di Paolo S, Stefanelli F et al (2019) The biomechanical role of meniscal allograft transplantation and preliminary in-vivo kinematic evaluation. J Exp Orthop 6:27. https://doi.org/10.1186/s40634-019-0196-2CrossRefPubMedPubMedCentral

11.

Kaleka CC, Netto AS, Silva JCA et al (2016) Which are the most reliable methods of predicting the meniscal size for transplantation? Am J Sports Med 44:2876–2883. https://doi.org/10.1177/0363546516653203CrossRefPubMed

12.

Pollard ME, Kang Q, Berg EE (1995) Radiographic sizing for meniscal transplantation. Arthrosc J Arthrosc Relat Surg 11:684–687. https://doi.org/10.1016/0749-8063(95)90110-8CrossRef

13.

Beeler S, Jud L, von Atzigen M et al (2020) Three-dimensional meniscus allograft sizing—a study of 280 healthy menisci. J Orthop Surg 15:74. https://doi.org/10.1186/s13018-020-01591-zCrossRef

14.

Beeler S, Vlachopoulos L, Jud L et al (2019) Contralateral MRI scan can be used reliably for three-dimensional meniscus sizing — retrospective analysis of 160 healthy menisci. The Knee 26:954–961. https://doi.org/10.1016/j.knee.2019.06.017CrossRefPubMed

15.

Bowers ME, Tung GA, Fleming BC et al (2007) Quantification of meniscal volume by segmentation of 3T magnetic resonance images. J Biomech 40:2811–2815. https://doi.org/10.1016/j.jbiomech.2007.01.016CrossRefPubMedPubMedCentral

16.

Getgood A, LaPrade RF, Verdonk P et al (2017) International Meniscus Reconstruction Experts Forum (IMREF) 2015 consensus statement on the practice of meniscal allograft transplantation. Am J Sports Med 45:1195–1205. https://doi.org/10.1177/0363546516660064CrossRefPubMed

17.

Stone KR, Freyer A, Turek T et al (2007) Meniscal sizing based on gender, height, and weight. Arthrosc J Arthrosc Relat Surg 23:503–508. https://doi.org/10.1016/j.arthro.2006.12.025CrossRef

18.

Wirth W, Frobell RB, Souza RB et al (2010) A three-dimensional quantitative method to measure meniscus shape, position, and signal intensity using MR images: a pilot study and preliminary results in knee osteoarthritis. Magn Reson Med 63:1162–1171. https://doi.org/10.1002/mrm.22380CrossRefPubMed

19.

Lim D, Han Lee Y, Kim S et al (2016) Clinical value of fat-suppressed 3D volume isotropic spin-echo (VISTA) sequence compared to 2D sequence in evaluating internal structures of the knee. Acta Radiol 57:66–73. https://doi.org/10.1177/0284185114567560CrossRefPubMed

20.

El-Liethy NE, Rashwan AS, Kamal H (2020) Single isotropic 3D fast spin echo sequence compared with conventional 2D sequences for detecting meniscal and cruciate ligament tears in the knee. Egypt J Radiol Nucl Med 51:258. https://doi.org/10.1186/s43055-020-00362-4CrossRef

21.

Van Thiel GS, Verma N, Yanke A et al (2009) Meniscal allograft size can be predicted by height, weight, and gender. Arthrosc J Arthrosc Relat Surg 25:722–727. https://doi.org/10.1016/j.arthro.2009.01.004CrossRef

22.

Wadhwa V, Omar H, Coyner K et al (2016) ISAKOS classification of meniscal tears—illustration on 2D and 3D isotropic spin echo MR imaging. Eur J Radiol 85:15–24. https://doi.org/10.1016/j.ejrad.2015.10.022CrossRefPubMed

23.

Koo TK, Li MY (2016) A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 15:155–163. https://doi.org/10.1016/j.jcm.2016.02.012CrossRefPubMedPubMedCentral

24.

Shen X, Zuo J, Li Z et al (2020) Morphological analysis of normal meniscus on magnetic resonance imaging (MRI)-based three-dimensional reconstruction models in healthy Chinese adults. Med Sci Monit 26. https://doi.org/10.12659/MSM.927101

25.

Messner K, Gao J (1998) The menisci of the knee joint. Anatomical and functional characteristics, and a rationale for clinical treatment. J Anat 193:161–178. https://doi.org/10.1046/j.1469-7580.1998.19320161.xCrossRefPubMedPubMedCentral

26.

Koh J, Zaffagnini S, Kuroda R et al (2021) Orthopaedic biomechanics in sports medicine. Springer International Publishing, ChamCrossRef

27.

Wenger A, Wirth W, Hudelmaier M et al (2013) Meniscus body position, size, and shape in persons with and persons without radiographic knee osteoarthritis: quantitative analyses of knee magnetic resonance images from the osteoarthritis initiative: meniscus position, size, and shape in OA. Arthritis Rheum 65:1804–1811. https://doi.org/10.1002/art.37947CrossRefPubMed

28.

Erbagci H, Gumusburun E, Bayram M et al (2004) The normal menisci: in vivo MRI measurements. Surg Radiol Anat 26:28–32. https://doi.org/10.1007/s00276-003-0182-2CrossRefPubMed

29.

A dos N, Kaleka CC S, Toma MK et al (2018) Should the meniscal height be considered for preoperative sizing in meniscal transplantation? Knee Surg Sports Traumatol Arthrosc 26:772–780. https://doi.org/10.1007/s00167-017-4461-6CrossRef

30.

Samitier G, Alentorn-Geli E, Taylor DC et al (2015) Meniscal allograft transplantation. Part 1: systematic review of graft biology, graft shrinkage, graft extrusion, graft sizing, and graft fixation. Knee Surg Sports Traumatol Arthrosc 23:310–322. https://doi.org/10.1007/s00167-014-3334-5CrossRefPubMed

31.

Yoon JP, Chang CB, Yoo JH et al (2010) Correlation of magnetic resonance imaging findings with the chronicity of an anterior cruciate ligament tear. J Bone Jt Surg 92:353–360. https://doi.org/10.2106/JBJS.I.00031CrossRef

32.

Beeler S, Vlachopoulos L, Jud L et al (2020) Meniscus sizing using three-dimensional models of the ipsilateral tibia plateau based on CT scans – an experimental study of a new sizing approach. J Exp Orthop 7:36. https://doi.org/10.1186/s40634-020-00252-8CrossRefPubMedPubMedCentral

33.

Tack A, Mukhopadhyay A, Zachow S (2018) Knee menisci segmentation using convolutional neural networks: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 26:680–688. https://doi.org/10.1016/j.joca.2018.02.907CrossRefPubMed

34.

Zhen T, Fang J, Hu D et al (2023) Risk stratification by nomogram of deep learning radiomics based on multiparametric magnetic resonance imaging in knee meniscus injury. Int Orthop. https://doi.org/10.1007/s00264-023-05875-x

Titel: Could a three-dimensional contralateral meniscus segmentation for allograft or scaffold sizing be possible? A prospective study
verfasst von: Valcarenghi Jérôme
Hernigou Jacques
Chahidi Esfandiar
Collard Xavier
Francotte Dorothée
Jennart Harold
Verdonk René
Publikationsdatum: 08.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 10/2023
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-023-05923-6

Chondrotoxic effects of tranexamic acid and povidone-iodine on the articular cartilage of rabbits

Original Paper

Risk stratification by nomogram of deep learning radiomics based on multiparametric magnetic resonance imaging in knee meniscus injury

Original Paper

Response to “Letter to the editor on “Fixation of patella fractures with metallic implants is associated with a significantly higher risk of complications and re-operations than non-metallic implants: a systematic review and meta-analysis””

Letter to the Editor

Increased rate of complications following total knee arthroplasty in patients with systemic sclerosis

Original Paper

Incomplete meniscal healing in early second-look arthroscopy does not indicate failure of repair: a case series

Open Access
Original Paper

Arthroscopic treatment of the symptomatic discoid lateral meniscus improves the knee function in the long-term: a ten-year follow-up study

Original Paper

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie erweitert durch Fallbeispiele, Videos und Abbildungen. Zur Fortbildung und Wissenserweiterung, verfasst und geprüft von Expertinnen und Experten der Gesellschaft für Arthroskopie und Gelenkchirurgie (AGA).

Jetzt entdecken!

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Positive Daten für supraskapulären Nervenblock bei Schultersteife

20.01.2025
Schultersteife
Nachrichten

Daten einer aktuellen Metaanalyse sprechen dafür, dass eine Blockade des Nervus suprascapularis bei Schultersteife mit Blick auf Funktion und Schmerzlinderung mindestens so effektiv ist wie eine Physiotherapie oder intraartikulär injizierte Steroide.

Wirbelgleiten: Dem persönlichen Drang zum Versteifen widerstehen!

17.01.2025
Spondylolisthese
Nachrichten

In einer norwegischen Studie schnitt die alleinige Dekompressions-Op. bei Personen mit Wirbelgleiten auch dann nicht schlechter ab, wenn erfahrene Chirurgen/ Chirurginnen eigentlich für eine zusätzliche Versteifung plädiert hätten.

Nackenschmerzen nach Bandscheibenvorfall: Muskeltraining hilft!

15.01.2025
Nackenschmerzen
Nachrichten

Bei hartnäckigen Schmerzen aufgrund einer zervikalen Radikulopathie schlägt ein Team der Universität Istanbul vor, lokale Steroidinjektionen mit einem speziellen Trainingsprogramm zur Stabilisierung der Nackenmuskulatur zu kombinieren.

Die elektronische Patientenakte kommt: Das sollten Sie jetzt wissen

12.01.2025
Elektronische Patientenakte
Nachrichten

Am 15. Januar geht die „ePA für alle“ zunächst in den Modellregionen an den Start. Doch schon bald soll sie in allen Praxen zum Einsatz kommen. Was ist jetzt zu tun? Was müssen Sie wissen? Wir geben in einem FAQ Antworten auf 21 Fragen.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Could a three-dimensional contralateral meniscus segmentation for allograft or scaffold sizing be possible? A prospective study