Osteoarthritis—a painful condition in which cartilage and bone become damaged—is the most common joint disorder in the U.S. It interferes with daily activities, and often leads to a total joint replacement. People who experience damage to the menisci —two wedge-shaped pieces of cartilage that cushion and stabilize the knee joint—have a 10 times higher risk of developing osteoarthritis than that of the general population. Meniscal damage is common among those who play sports, such as soccer, and in older people. When menisci are injured, they can no longer effectively distribute forces across the knee joint, so areas of the knee end up experiencing “high contact stresses” thereby becoming overloaded.
Working to improve surgical outcomes
For patients who have severe and widespread meniscal damage, there are two treatment options: remove the meniscus and insert a graft, or remove the meniscus and do nothing else. Some who receive the graft do well, but others don’t. To find out why some patients develop osteoarthritis after graft implantation, scientists and clinicians in HSS Biomechanics, Imaging and Sports Medicine are collaborating on a study. The research team includes Suzanne Maher, PhD, Associate Director of the Department of Biomechanics; Scott A. Rodeo, MD, Co-Chief Emeritus of the Sports Medicine and Shoulder Service and Attending Orthopedic Surgeon; and Matthew Koff, PhD, Associate Scientist in the Department of Radiology and Imaging. In a recent pilot, the team developed a device that “loads” the knee during an MRI scan. The scans give researchers a better sense of the health of the meniscal tissue; for instance, they can reveal whether the tissue is deforming when a load is applied. In the study, patients had MRI scans before and after meniscal surgery, and the researchers found preliminary data suggesting that those patients with areas of high contact stresses were most likely to experience tissue degeneration later.
A surgical “trial run” for the best results
The goal of this research is to predict and ultimately prevent a patient’s risk of osteoarthritis following meniscal surgery. Using the MRI scans, our experts can create a computer model to predict how the mechanics of the joint will change in a virtual surgery simulation. Eventually, a surgeon might be able to tailor the procedure to a patient’s specific needs and address the areas that are at risk of developing osteoarthritis.
Dr. Scott Rodeo is an orthopedic surgeon and the co-chief emeritus of the Sports Medicine and Shoulder Service at Hospital for Special Surgery. He specializes in sports medicine injuries of the knee, shoulder, ankle, and elbow.
Dr. Matthew F. Koff, PhD, is an Assistant Scientist at Hospital for Special Surgery, in the Department of Radiology and Imaging – MRI Division. Curently, Dr. Koff works in the MRI Lab at HSS and performs research to aid in the diagnosis and treatment of patients of all ages.
Dr. Suzanne Maher, PhD, works in multi-disciplinary teams which blend experimental, computational, and statistical models with the clinical expertise of orthopedic surgeons. As a member of the Department of Biomechanics and the Orthopedic Soft Tissue Research Program at Hospital for Special Surgery, she works closely with faculty from both groups.