{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:18:30Z","timestamp":1793193510027,"version":"4.5.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2025,11]]},"abstract":"\n Background:<\/jats:title>\n Medial meniscal extrusion (MME) is a risk factor for osteoarthritis of the knee and is usually assessed using a supine, unloaded magnetic resonance imaging. However, protocols for examining meniscal extrusion with ultrasound in the literature vary regarding specific flexion angles and the extent of weightbearing during the examination, complicating interpretations of the influence of loading and position on meniscal extrusion.<\/jats:p>\n <\/jats:sec>\n \n Hypothesis:<\/jats:title>\n The hypothesis was that loading and increased flexion angles would increase physiologic MME relative to supine and neutral positions.<\/jats:p>\n <\/jats:sec>\n \n Study Design:<\/jats:title>\n Descriptive laboratory study.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Asymptomatic volunteers with no history of knee pain, injury, or surgery were included. Real-time knee joint angles were obtained by a motion-capture system using retroreflective markers placed on the lower limbs. Ultrasound images of the medial meniscus of both knees were acquired in the coronal plane for supine, single-leg, and double-leg standing positions and with the knee in neutral (0\u00b0-5\u00b0), 20\u00b0, and 45\u00b0 of flexion. MME was compared across legs, stances, and angles using a repeated-measures mixed-effects linear model, and pairwise comparisons were made using a post hoc Tukey test.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 21 volunteers (age, 33 \u00b1 12 years; body mass index, 23 \u00b1 2.3 kg\/m\n 2<\/jats:sup>\n ; 9 women) participated in the study. MME was significantly lower in the supine position compared with single- and double-leg stances (\n P<\/jats:italic>\n < .0001, estimated marginal mean MME: supine = 1.1, 1-leg = 1.3, 2-leg = 1.3), with no significant difference between weightbearing stances. Increasing knee flexion angles were associated with significantly lower extrusion (\n P<\/jats:italic>\n < .0001, estimated marginal mean MME: neutral = 1.4; 20\u00b0 = 1.3; 45\u00b0 = 1), with extrusion greatest at neutral flexion and lowest at 45\u00b0 of flexion. There was no significant difference in MME between right and left legs (estimated marginal mean MME = 1.2 for both left and right legs;\n P<\/jats:italic>\n = .7255).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Our study demonstrated that unloaded, supine examinations of MME may be of limited value. Also, including ultrasound assessment under loaded conditions may better reflect the biomechanical function of the meniscus during activities of daily life.<\/jats:p>\n <\/jats:sec>\n \n Clinical Relevance:<\/jats:title>\n Examining physiologic meniscal behavior is important to provide context for altered meniscal function in the presence of pathology, which may help inform clinical decisions regarding the management of meniscal degeneration or tears.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/23259671251391777","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T17:58:02Z","timestamp":1763402282000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Physiologic Medial Meniscal Extrusion With Loading and Flexion Detected by Ultrasound"],"prefix":"10.1177","volume":"13","author":[{"given":"Maria E.","family":"Dey Hazra","sequence":"first","affiliation":[{"name":"The Steadman Philippon Research Institute, Vail, Colorado, USA"},{"name":"Orthop\u00e4dische Privatpraxis Dr. Kuhlee, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rony-Orijit","family":"Dey Hazra","sequence":"additional","affiliation":[{"name":"The Steadman Philippon Research Institute, Vail, Colorado, USA"},{"name":"Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charit\u00e9\u2013 University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Kruse","sequence":"additional","affiliation":[{"name":"The Steadman Philippon Research Institute, Vail, Colorado, USA"},{"name":"Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"The Steadman Philippon Research Institute, Vail, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1682-0444","authenticated-orcid":false,"given":"Justin","family":"Hollenbeck","sequence":"additional","affiliation":[{"name":"The Steadman Philippon Research Institute, Vail, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8298-3746","authenticated-orcid":false,"given":"Peter J.","family":"Millett","sequence":"additional","affiliation":[{"name":"The Steadman Clinic, Vail, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Vidal","sequence":"additional","affiliation":[{"name":"The Steadman Clinic, Vail, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Tashman","sequence":"additional","affiliation":[{"name":"The Steadman Philippon Research Institute, Vail, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E.","family":"Watkins","sequence":"additional","affiliation":[{"name":"The Steadman Philippon Research Institute, Vail, Colorado, USA"},{"name":"Department of Radiology, Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-4885-7"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-08604-3"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12998-021-00390-5"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2014.07.008"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15975"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671231151698"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2020.05.017"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671241248457"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5341-4"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-01531-9"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43019-022-00163-1"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/jum.16507"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14976"},{"key":"e_1_3_2_16_2","first-page":"33","article-title":"Meniscal extrusion as booster of osteoarthritis","volume":"31","author":"Papalia R","year":"2017","unstructured":"Papalia R, Papalia G, Russo F, et al. 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