Culvenor Adam G, Wirth Wolfgang, Maschek Susanne, Boeth Heide, Diederichs Gerd, Duda Georg, Eckstein Felix
Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremburg, Strubergasse 21, A5020, Salzburg, Austria; La Trobe Sports & Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Kingsbury Drive, Bundoora 3086, Victoria, Australia.
Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremburg, Strubergasse 21, A5020, Salzburg, Austria.
Eur J Radiol. 2017 Jul;92:24-29. doi: 10.1016/j.ejrad.2017.04.018. Epub 2017 Apr 25.
Patellofemoral cartilage changes have been evaluated in knee trauma and osteoarthritis; however, little is known about changes in patellar and trochlear cartilage thickness, T2 relaxation-time and subchondral bone plate area (tAB) during growth. Our prospective study aimed to explore longitudinal change in patellofemoral cartilage thickness, T2 and tAB in adolescent athletes, and to compare these data with those of mature (i.e., adult) athletes.
20 adolescent (age 16±1years) and 20 mature (46±5years) volleyball players were studied over 2-years (10 men and 10 women each group). 1.5T MRI 3D-VIBE and multi-echo spin-echo sequences were acquired at baseline and 2-year follow-up. Using manual segmentation and 3D reconstruction, longitudinal changes in patellar and trochlear cartilage thickness, patellar cartilage T2 (mono-exponential decay curve with five echoes [9.7-67.9ms]), and patellar and trochlear tAB were determined.
The annual increase in both patellar and trochlear cartilage thickness was 0.8% (95% confidence interval [CI] 0.6, 1.0) and 0.6% (0.3, 0.9), for adolescent males and females respectively; the longitudinal gain in patellar and trochlear tAB was 1.3% (1.1, 1.5) and 0.5% (0.2, 0.8), and 1.6% (1.1, 2.2) and 0.8% (0.3, 0.7) for adolescent males and females, respectively (no significant between-sex differences). Mature athletes showed smaller gains in tAB, and loss of <1% of cartilage thickness annually. While no significant sex-differences existed in adolescent patellar T2 changes, mature males gained significantly greater T2 than mature females (p=0.002-0.013).
Patellar and trochlear cartilage thickness and tAB were observed to increase in young athletes in late adolescence, without significant differences between sexes. Mature athletes displayed patellar cartilage loss (and T2 increases in mature males), potentially reflecting degenerative changes.
髌股关节软骨变化已在膝关节创伤和骨关节炎中得到评估；然而，对于生长过程中髌骨和滑车软骨厚度、T2弛豫时间及软骨下骨板面积（tAB）的变化知之甚少。我们的前瞻性研究旨在探讨青少年运动员髌股关节软骨厚度、T2及tAB的纵向变化，并将这些数据与成熟（即成年）运动员的数据进行比较。
对20名青少年（年龄16±1岁）和20名成熟（46±5岁）排球运动员进行了为期2年的研究（每组10名男性和10名女性）。在基线和2年随访时采集1.5T MRI 3D-VIBE和多回波自旋回波序列。使用手动分割和三维重建，确定髌骨和滑车软骨厚度、髌骨软骨T2（具有五个回波的单指数衰减曲线[9.7 - 67.9毫秒]）以及髌骨和滑车tAB 的纵向变化。
青少年男性和女性的髌骨和滑车软骨厚度年增长率分别为分别为0.8%（95%置信区间[CI] 0.6, 1.0）和0.6%（0.3, 0.9）；青少年男性和女性的髌骨和滑车tAB的纵向增加率分别为1.3%（1.1, 1.5）和0.5%（0.2, 0.8），以及1.6%（1.1, 2.2）和0.8%（0.3, 0.7）（性别间无显著差异）。成熟运动员的tAB增加较小，且软骨厚度每年损失<1%。虽然青少年髌骨T2变化不存在显著性别差异，但成熟男性的T2增加显著大于成熟女性（p = 0.002 - 0.013）。
在青春期后期的年轻运动员中观察到髌骨和滑车软骨厚度及tAB增加，性别间无显著差异。成熟运动员出现髌骨软骨丢失（成熟男性T2增加），这可能反映了退行性变化。
