Grammens Jonas, Van Haver Annemieke, Danckaers Femke, Booth Brian, Sijbers Jan, Verdonk Peter
Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium.
imec-VisionLab, Department of Physics, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium.
Knee Surg Sports Traumatol Arthrosc. 2021 Jun;29(6):1777-1789. doi: 10.1007/s00167-020-06218-8. Epub 2020 Aug 14.
Early-onset degeneration of the knee is linked to genetics, overload, injury, and potentially, knee morphology. The purpose of this study is to explore the characteristics of the small medial femoral condyle, as a distinct knee morphotype, by means of a landmark-based three-dimensional (3D) analysis and statistical parametric mapping.
Sixteen knees with a small medial femoral condyle (SMC) were selected from a database of patients with distinct knee joint anatomy and 16 gender-matched knees were selected from a control group database. 3D models were generated from the medical imaging. After normalization for size, a set of pre-defined landmark-based parameters was analysed for the femur and tibia. Local shape differences were evaluated by matching all bone surfaces onto each other and comparing the distances to the mean control group bone shape.
The small medial condyle group showed a significant association with medial compartment degeneration and had a 4% and 13% smaller medial condyle anteroposteriorly and mediolaterally, whereas the distal femur was 3% wider mediolaterally. The lateral condyle was 2% smaller anteroposteriorly and 8% wider mediolaterally. The complete tibial plateau was 3% smaller mediolaterally and the medial tibial plateau was 6% smaller.
A new knee morphotype demonstrated an increased risk for medial compartment degeneration and was differentiated from a healthy control group based on the following morphological characteristics: a smaller medial femoral condyle and medial tibial plateau, a wider lateral femoral condyle and a wider distal femur on a smaller tibial plateau. This pilot study suggests a role for the SMC knee morphotype in the multifactorial process of medial compartment degeneration.
III.
膝关节早发性退变与遗传、负荷过重、损伤以及可能的膝关节形态有关。本研究的目的是通过基于地标点的三维（3D）分析和统计参数映射，探索小内侧股骨髁作为一种独特膝关节形态类型的特征。
从具有独特膝关节解剖结构的患者数据库中选取16个内侧股骨髁较小（SMC）的膝关节，并从对照组数据库中选取16个性别匹配的膝关节。通过医学影像生成3D模型。在对大小进行归一化后，分析股骨和胫骨的一组预定义的基于地标点的参数。通过将所有骨表面相互匹配并比较与平均对照组骨形状的距离来评估局部形状差异。
小内侧髁组与内侧间室退变显著相关，其内侧髁前后径和内外径分别小4%和13%，而股骨远端内外径宽3%。外侧髁前后径小2%，内外径宽8%。整个胫骨平台内外径小3%，内侧胫骨平台小6%。
一种新的膝关节形态类型显示内侧间室退变风险增加，并且基于以下形态特征与健康对照组相区分：较小的内侧股骨髁和内侧胫骨平台、较宽的外侧股骨髁以及较小胫骨平台上较宽的股骨远端。这项初步研究表明SMC膝关节形态类型在内侧间室退变的多因素过程中起作用。
III级。
