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Patterns of cartilage degeneration in knees with medial tibiofemoral offset

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Abstract

Objective

To determine if radiographic medial tibiofemoral offset (MTFO) is associated with: (1) magnetic resonance imaging (MRI) pathology of cartilage, meniscus, and ligament; and (2) a distinct pattern of lateral cartilage degeneration on MRI.

Materials and methods

Three hundred consecutive adult knee MRIs with anteroposterior (AP) radiographs were retrospectively reviewed, and 145 studies were included. MTFO was defined as a medial extension of the medial femoral condyle beyond the articular surface of the medial tibial plateau on weight-bearing AP radiographs. The patients were then divided into the MTFO (n = 61) or no-offset (n = 84) groups. On MRI data obtained on a 1.5-Tesla system, articular cartilage of the femoral condyle and tibial plateau were graded using a modified Outerbridge classification (36 sub-regions similar to whole-organ MRI Score (WORMS) system). In addition, MR pathology of the ACL, MCL, LCL, medial and lateral menisci, were determined.

Results

Significantly increased (ANOVA p < 0.007) MR grade of the ligaments, menisci, and cartilage in the MTFO group (ranging from 0.3 to 2.5) compared to the control group (0.2 to 1.1). Color maps of the cartilage grades suggested a marked difference in both severity of degeneration and regional variations between the groups. MTFO group exhibited focally increased cartilage grades in the central, non-weight regions of lateral compartment (region p = 0.07 to 0.12, interaction p = 0.05 to 0.1).

Conclusions

MTFO is associated with overall degeneration of the knee and features a distinct lateral cartilage degeneration pattern, which may reflect non-physiologic contact of the cartilage between the lateral tibial eminence and lateral central femoral condyle.

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Authors and Affiliations

  1. Department of Radiology, VA San Diego Healthcare System, 3350 La Jolla Village Dr., MC-114, San Diego, CA, 92161, USA

    Karen C. Chen, Sheronda Statum, Amilcare Gentili & Christine B. Chung

  2. Department of Radiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Palanan Siriwanarangsun

  3. Department of Radiology, University of California, San Diego, School of Medicine, San Diego, CA, USA

    Palanan Siriwanarangsun, Karen C. Chen, Tim Finkenstaedt, Won C. Bae, Sheronda Statum, Amilcare Gentili & Christine B. Chung

  4. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Tim Finkenstaedt

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  1. Palanan Siriwanarangsun
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Correspondence to Christine B. Chung.

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Conflict of interest

This study was supported by the following grants: scholarship of Faculty of Medicine Siriraj Hospital. We disclose any financial support or author involvement with organization(s) with financial interest in the subject matter.

IRB statement

This study was approved by the local ethical committee of the VA San Diego Healthcare System (IRB number 160142). All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Written informed consent was waived by the local ethical committee.

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Siriwanarangsun, P., Chen, K.C., Finkenstaedt, T. et al. Patterns of cartilage degeneration in knees with medial tibiofemoral offset. Skeletal Radiol 48, 931–937 (2019). https://doi.org/10.1007/s00256-018-3093-3

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  • DOI: https://doi.org/10.1007/s00256-018-3093-3

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