Large‐Scale Analysis of Meniscus Morphology as Risk Factor for Knee Osteoarthritis

Objective Although it is established that structural damage of the meniscus is linked to knee osteoarthritis (OA) progression, the predisposition to future development of OA because of geometric meniscal shapes is plausible and unexplored. This study aims to identify common variations in meniscal shape and determine their relationships to tissue morphology, OA onset, and longitudinal changes in cartilage thickness. Methods A total of 4,790 participants from the Osteoarthritis Initiative data set were studied. A statistical shape model was developed for the meniscus, and shape scores were evaluated between a control group and an OA incidence group. Shape features were then associated with cartilage thickness changes over 8 years to localize the relationship between meniscus shape and cartilage degeneration. Results Seven shape features between the medial and lateral menisci were identified to be different between knees that remain normal and those that develop OA. These include length‐width ratios, horn lengths, root attachment angles, and concavity. These “at‐risk” shapes were linked to unique cartilage thickness changes that suggest a relationship between meniscus geometry and decreased tibial coverage and rotational imbalances. Additionally, strong associations were found between meniscal shape and demographic subpopulations, future tibial extrusion, and meniscal and ligamentous tears. Conclusion This automatic method expanded upon known meniscus characteristics that are associated with the onset of OA and discovered novel shape features that have yet to be investigated in the context of OA risk.