Knee joint anterior malalignment and patellofemoral osteoarthritis: an MRI study

Tsavalas, Nikolaos; Katonis, Pavlos; Karantanas, Apostolos H.

doi:10.1007/s00330-011-2275-3

Cited by 60 publications

(57 citation statements)

References 50 publications

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“…). All included subjects exhibited patellotrochlear indices, lateral trochlear inclination angles, and mean osseous sulcus angles within the normal ranges as defined in the literature …”

Section: Resultsmentioning

confidence: 99%

“…All included subjects exhibited patellotrochlear indices, lateral trochlear inclination angles, and mean osseous sulcus angles within the normal ranges as defined in the literature. [29][30][31] The intercartilage distance as calculated from the segmentation results is illustrated for one healthy subject (male, 31 years) as a color-coded map on the 3D cartilage surface (Fig. 3).…”

Section: Resultsmentioning

confidence: 99%

“…Only volunteers without a history of knee pain or relevant knee trauma were included. For all subjects, trochlea configuration and patella position were determined by estimation of the patellotrochlear index, lateral trochlear inclination angle, and mean osseous sulcus angle . Subjects were asked to refrain from activities involving considerable knee loading during the last few hours before the experiments.…”

Section: Methodsmentioning

confidence: 99%

“…For all subjects, trochlea configuration and patella position were determined by estimation of the patellotrochlear index, 29 lateral trochlear inclination angle, 30 and mean osseous sulcus angle. 31 Subjects were asked to refrain from activities involving considerable knee loading during the last few hours before the experiments. To assess the reproducibility of the method, the loaded MRI experiments were performed three times in one subject with a delay of several weeks between measurements.…”

Section: Methodsmentioning

confidence: 99%

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Quantification of patellofemoral cartilage deformation and contact area changes in response to static loading via high‐resolution MRI with prospective motion correction

Lange

Taghizadeh

Knowles

et al. 2019

Magnetic Resonance Imaging

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Background Higher‐resolution MRI of the patellofemoral cartilage under loading is hampered by subject motion since knee flexion is required during the scan. Purpose To demonstrate robust quantification of cartilage compression and contact area changes in response to in situ loading by means of MRI with prospective motion correction and regularized image postprocessing. Study Type Cohort study. Subjects Fifteen healthy male subjects. Field Strength 3 T. Sequence Spoiled 3D gradient‐echo sequence augmented with prospective motion correction based on optical tracking. Measurements were performed with three different loads (0/200/400 N). Assessment Bone and cartilage segmentation was performed manually and regularized with a deep‐learning approach. Average patellar and femoral cartilage thickness and contact area were calculated for the three loading situations. Reproducibility was assessed via repeated measurements in one subject. Statistical Tests Comparison of the three loading situations was performed by Wilcoxon signed‐rank tests. Results Regularization using a deep convolutional neural network reduced the variance of the quantified relative load‐induced changes of cartilage thickness and contact area compared to purely manual segmentation (average reduction of standard deviation by ∼50%) and repeated measurements performed on the same subject demonstrated high reproducibility of the method. For the three loading situations (0/200/400 N), the patellofemoral cartilage contact area as well as the mean patellar and femoral cartilage thickness were significantly different from each other (P < 0.05). While the patellofemoral cartilage contact area increased under loading (by 14.5/19.0% for loads of 200/400 N), patellar and femoral cartilage thickness exhibited a load‐dependent thickness decrease (patella: –4.4/–7.4%, femur: –3.4/–7.1% for loads of 200/400 N). Data Conclusion MRI with prospective motion correction enables quantitative evaluation of patellofemoral cartilage deformation and contact area changes in response to in situ loading. Regularizing the manual segmentations using a neural network enables robust quantification of the load‐induced changes. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1561–1570.

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“…). All included subjects exhibited patellotrochlear indices, lateral trochlear inclination angles, and mean osseous sulcus angles within the normal ranges as defined in the literature …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Quantification of patellofemoral cartilage deformation and contact area changes in response to static loading via high‐resolution MRI with prospective motion correction

Lange

Taghizadeh

Knowles

et al. 2019

Magnetic Resonance Imaging

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“…Because normal patellar alignment in relation to the trochlear groove has important implications for proper load bearing (7, 8), improper alignment or tracking are hypothesized to lead to chondromalacia, chondrosis, early osteoarthritis, synovial proliferation, subchondral bony changes, and fat pad impingement, all of which can cause pain, and eventually joint degeneration (9–11). Regional quantification of the transverse relaxation time constant (T2 mapping) offers a sensitive imaging method for early detection of changes in collagen anisotropy and hydration status (12).…”

Section: Introductionmentioning

confidence: 99%

Patellofemoral Friction Syndrome

Subhawong

Thakkar

Padua

et al. 2014

Journal of Computer Assisted Tomography

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OBJECTIVE To investigate whether patellofemoral T2 cartilage changes are associated with lateral patellofemoral friction syndrome (PFS), as indicated by edema-like signal within the superolateral infrapatellar (Hoffa) fat pad. METHODS In this IRB-approved retrospective study of 510 consecutive patients, 49 patients with 50 knee MR imaging exams demonstrating normal or low-grade patellofemoral cartilage abnormalities (WORMS score ≤2) were included. 22 exams with PFS (cases) were compared with an age- and gender-matched cohort of 28 exams without PFS (controls). 3T MR imaging was performed with multi-echo, spin echo T2 mapping. Two readers measured in consensus malalignment parameters, including patellar height index, tibial tuberosity to trochlear groove distance (TT-TG), and sulcus angle. Bulk T2 cartilage values in the lateral and medial patellofemoral compartment, central weight-bearing medial and lateral femoral condyles were measured independently. Interobserver agreement was quantified using concordance correlation coefficients (CCC). Demographics, anatomic measurements, WORMS scores, and cartilage T2 values were compared between cases and controls using Fisher’s exact test, Wilcoxon rank-sum, and mixed effects models. RESULTS Cases demonstrated higher patellar height index (p=0.002) and TT-TG (p=0.02). Interobserver agreement for T2 values was good overall (CCC range: 0.65–0.93). Cases demonstrated higher medial facet patellar bulk T2 (38.1±7.5 ms) versus controls (33.6±7.3 ms) (p=0.02); otherwise there were no significant differences in regional T2 values. CONCLUSION T2 mapping in patients with PFS demonstrates increased cartilage T2 in the medial patellar facet, possibly reflecting collagen alteration from early chondromalacia (softening) or increased water content related to altered contact pressures.

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Is Tibiofemoral or Patellofemoral Alignment or Trochlear Morphology Associated With Patellofemoral Osteoarthritis? A Systematic Review

Macri

Stefanik

Khan

et al. 2016

Arthritis Care & Research

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Knee joint anterior malalignment and patellofemoral osteoarthritis: an MRI study

Abstract: • MRI is an excellent method to evaluate knee alignment and articular cartilage damage. • Significant associations exist between alignment parameters and osteoarthritis of the patellofemoral joint. • The "sulcus angle" and "sulcus depth" were the most valuable osteoarthritic markers.

Cited by 60 publications

References 50 publications

Quantification of patellofemoral cartilage deformation and contact area changes in response to static loading via high‐resolution MRI with prospective motion correction

Quantification of patellofemoral cartilage deformation and contact area changes in response to static loading via high‐resolution MRI with prospective motion correction

Patellofemoral Friction Syndrome

Is Tibiofemoral or Patellofemoral Alignment or Trochlear Morphology Associated With Patellofemoral Osteoarthritis? A Systematic Review

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