Skeletal Radiology

, Volume 42, Issue 10, pp 1383–1392

Association of trochlear dysplasia with degenerative abnormalities in the knee: data from the Osteoarthritis Initiative

Authors

    • Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical imagingUniversity of California San Francisco
    • Department of RadiologyTechnical University of Munich
  • Seng-Choe Tham
    • Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical imagingUniversity of California San Francisco
    • Department of RadiologyMount Elizabeth Hospital
  • Hans Liebl
    • Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical imagingUniversity of California San Francisco
    • Department of RadiologyTechnical University of Munich
  • Michael C. Nevitt
    • Department of Epidemiology and BiostatisticsUniversity of California San Francisco
  • Charles E. McCulloch
    • Department of Epidemiology and BiostatisticsUniversity of California San Francisco
  • John Lynch
    • Department of Epidemiology and BiostatisticsUniversity of California San Francisco
  • Thomas M. Link
    • Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical imagingUniversity of California San Francisco
Scientific Article

DOI: 10.1007/s00256-013-1664-x

Cite this article as:
Jungmann, P.M., Tham, S., Liebl, H. et al. Skeletal Radiol (2013) 42: 1383. doi:10.1007/s00256-013-1664-x

Abstract

Objective

To evaluate trochlear morphology as a potential risk factor for patellofemoral osteoarthritis, determined by morphological and quantitative measurements of cartilage degeneration using 3-T magnetic resonance imaging (MRI) of the knee.

Materials and methods

MRI of the right knees of 304 randomly selected subjects, aged 45–60 years, from the Osteoarthritis Initiative (OAI) progression cohort were screened for trochlear dysplasia, defined by an abnormal trochlear depth. Out of 304 subjects, n = 85 demonstrated a shallow trochlea (depth ≤3 mm; 28 %). In these, and also in a random sample of controls with normal trochlear depth (n = 50), the facet ratio and the sulcus angle were calculated and knee structural abnormalities were assessed by using a modified Whole Organ MR Imaging Score (WORMS). Cartilage segmentation was performed and T2 relaxation times and patellar cartilage volume were determined. ANOVA and multivariate regression models were used for statistical analysis of the association of MRI structural measures and trochlear morphology.

Results

Knees with a shallow trochlea showed higher patellofemoral degeneration (WORMS mean ± standard deviation, 11.2 ± 0.5 versus 5.7 ± 0.6; multivariate regression, P < 0.001) and lower patellar cartilage volume than controls (900 ± 664 mm3 versus 1,671 ± 671 mm3; P < 0.001). Knees with an abnormal medial-to-lateral facet ratio (<0.4) showed increased patellofemoral WORMS scores (12.3 ± 0.9 versus 8.3 ± 0.5; P < 0.001). Knees with an abnormal sulcus angle (>170°) also showed increased WORMS scores (12.2 ± 1.1 versus 8.6 ± 0.6; P = 0.003). T2 values at the patella were significantly lower in the dysplasia group with a shallow trochlea. However, significance was lost after adjustment for cartilage volume (P = 0.673).

Conclusion

Trochlear dysplasia, defined by a shallow trochlea, was associated with higher WORMS scores and lower cartilage volume, indicating more advanced osteoarthritis at the patellofemoral joint.

Keywords

Patellofemoral jointMagnetic resonance imagingOsteoarthritisCartilage

Copyright information

© ISS 2013