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A. Guermazi

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Review Open access Aug 2026

Association between radial meniscal tears with and without posterior root involvement and subchondral insufficiency fracture of the knee: the mediating role of meniscal extrusion

Purpose The purpose of this study was to assess the association between knee subchondral insufficiency fracture (SIF) and radial meniscal tears and evaluated medial meniscal extrusion as a mediator. Materials and methods A retrospective matched case-control study of knee MRIs obtained from November 2021 to November 2024 was performed. MRIs were reviewed for SIF, meniscal tear morphology, and meniscal extrusion grade. Associations between radial tears and SIF (overall and medial compartment) were evaluated using conditional logistic regression adjusted for age, sex, and body mass index. Medial-compartment mediation was examined using a natural effects model with medial meniscal extrusion as the mediator. Results The cohort included 343 patients with SIF (65.4 ± 10.1 [standard deviation] years; 226 women) and 343 patients without SIF (66.4 ± 10.0 [standard deviation] years; 224 women). Compared with knees without radial tears, odds of SIF were higher in the presence of radial root tears (odds ration [OR], 7.62; 95% confidence interval [CI]: 4.40–13.21) and radial non-root tears (OR, 5.26; 95% CI: 2.48–11.15), with similar findings in the medial compartment. In mediation analysis, medial radial root tears showed an indirect association with medial SIF through medial meniscal extrusion (OR, 1.46; 95% CI: 1.16–1.84), accounting for 16.6% of the total effect. Conclusion Radial root and non-root tears were strongly associated with SIF, particularly in the medial compartment. Meniscal extrusion explained a small proportion of this association, suggesting that additional biomechanical pathways are likely in play.

M. Alzaher, Wasim Issa, A. Huang et al. · 1 citation
Open access Aug 2026

Associations of Popliteal Artery Wall Morphology at MRI and Knee Osteoarthritis in the Osteoarthritis Initiative.

Background Vascular factors have been associated with osteoarthritis (OA), but the association between popliteal artery wall morphology and symptomatic and radiographic knee OA outcomes over time remains unclear. Purpose To evaluate the associations between MRI-derived measures of popliteal artery wall morphology (localized wall thickening and global wall burden) and symptomatic and radiographic knee OA outcomes. Materials and Methods In this secondary analysis of the Osteoarthritis Initiative (February 2004 to October 2015), baseline knee MRI scans were analyzed to quantify maximum wall thickness and normalized wall index (NWI). Symptomatic OA was assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores, and radiographic OA using Kellgren-Lawrence (KL) grade. Cross-sectional and longitudinal associations were assessed using linear regression and Cox proportional hazards models, respectively, adjusted for demographic and clinical covariates. Results A total of 9333 knees from 4710 participants (mean age, 61.1 years ± 9.2 [SD]; 2753 female) were included. Each 1-mm increase in maximum wall thickness was associated with higher WOMAC pain scores (β = 2.0; P < .001) and KL grades (β = 0.1; P < .001), as well as symptomatic worsening (hazard ratio = 1.10 [95% CI: 1.02, 1.19]; P = .02) and incident radiographic OA (hazard ratio = 1.21 [95% CI: 1.02, 1.44]; P = .044). Each 10% increase in NWI was associated with higher WOMAC pain scores (β = 6.7; P < .001) and symptomatic worsening (hazard ratio = 1.38 [95% CI: 1.20, 1.58]; P < .001) but was inversely associated with KL grade (β = -0.1; P = .001) and incident radiographic OA (hazard ratio = 0.60 [95% CI: 0.43, 0.83]; P = .004). Conclusion Localized popliteal arterial wall thickening was associated with symptomatic OA worsening and incident radiographic OA, whereas diffuse wall remodeling was associated with symptomatic OA worsening and was inversely associated with radiographic outcomes. Clinical trial registration no. NCT00080171 © RSNA, 2026 Supplemental material is available for this article. See also the editorial by Jarraya and Harandi in this issue.

F. Pishgar, Peyman Mirghaderi, Ehsan Alipour et al. · 1 citation
Open access Aug 2026

Association between low bone mineral density and subchondral insufficiency fractures of the knee in women, and influence of radial meniscal root tears

Osteoporosis is associated with higher odds of SIF of the knee in women, while osteopenia is not, and small strata likely limited the power to detect a significant effect modification.

M. Alzaher, Wasim Issa, Tuhina Neogi et al. · 0 citations

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