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

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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.

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Acknowledgements

This study was funded by NIH U01 AR059507 and P50 AR060752 as well as through the OAI, which is a public–private partnership comprising five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health.

Conflict of interest

No conflict of interest to declare for any of the authors.

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Authors and Affiliations

  1. Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA

    Pia M. Jungmann, Seng-Choe Tham, Hans Liebl & Thomas M. Link

  2. Department of Epidemiology and Biostatistics, University of California San Francisco, 185 Berry Street, Suite 5700, San Francisco, CA, 94107, USA

    Michael C. Nevitt, Charles E. McCulloch & John Lynch

  3. Department of Radiology, Mount Elizabeth Hospital, 3 Mount Elizabeth #01-01, Singapore, 228510, Singapore

    Seng-Choe Tham

  4. Department of Radiology, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany

    Pia M. Jungmann & Hans Liebl

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  1. Pia M. Jungmann
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  2. Seng-Choe Tham
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  3. Hans Liebl
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  4. Michael C. Nevitt
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  5. Charles E. McCulloch
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  7. Thomas M. Link
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Correspondence to Pia M. Jungmann.

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Jungmann, P.M., Tham, SC., Liebl, H. et al. Association of trochlear dysplasia with degenerative abnormalities in the knee: data from the Osteoarthritis Initiative. Skeletal Radiol 42, 1383–1392 (2013). https://doi.org/10.1007/s00256-013-1664-x

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  • DOI: https://doi.org/10.1007/s00256-013-1664-x

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