Eijkenboom J F A, Tümer N, Schiphof D, Oei E H, Zadpoor A A, Bierma-Zeinstra S M A, van Middelkoop M
Department of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands.
Department of Biomechanical Engineering, Delft University of Technology, the Netherlands.
Osteoarthritis Cartilage. 2023 Apr;31(4):534-542. doi: 10.1016/j.joca.2022.12.008. Epub 2023 Jan 7.
To examine the association between 3D patellar shape and 1) isolated magnetic resonance imaging (MRI)-based patellofemoral osteoarthritis (PFOA), 2) the morphological features of PFOA, and 3) the clinical symptoms of PFOA.
MRI data from 66 women with isolated MRI-based PFOA and 66 age- and BMI-matched healthy women were selected from a cohort study. The patellae were manually segmented from MRI scans and used to create a 3D statistical shape model (SSM) of the patella. Structural abnormalities were semi-standardized scored on MRI using MRI osteoarthritis knee score (MOAKS). Regression analyses were applied to determine the associations between the shape parameters retrieved from the SSM, group status, clinical symptoms, and structural abnormalities.
Four shape variants showed a statistically significant (<0.05) association with the group status. The mode responsible for most of the shape variations showed participants with PFOA possess a relatively thicker dorsal bump on the articular part of the patella, compared to patellae of control participants. Three of these variants showed an association with the presence of osteophytes and cartilage loss on the patella. Multiple associations were found between patellar shape and the clinical symptoms of PFOA.
Patellar shape is associated with the prevalence of MRI-based PFOA in women. Some shape variants were also associated with clinical symptoms. Interestingly, one particular shape variant associated with the presence of MRI-based PFOA was earlier shown to be associated with structural abnormalities associated with OA in a population aged under 40. This may suggest that patellar shape may be an early detectable risk factor for PFOA.
研究三维髌骨形状与1）基于磁共振成像（MRI）的孤立性髌股骨关节炎（PFOA）、2）PFOA的形态学特征以及3）PFOA的临床症状之间的关联。
从一项队列研究中选取66名患有基于MRI的孤立性PFOA的女性和66名年龄及体重指数匹配的健康女性的MRI数据。通过手动从MRI扫描中分割出髌骨，并用于创建髌骨的三维统计形状模型（SSM）。使用MRI膝骨关节炎评分（MOAKS）对MRI上的结构异常进行半标准化评分。应用回归分析来确定从SSM中获取的形状参数、组状态、临床症状和结构异常之间的关联。
四个形状变体与组状态显示出统计学上的显著关联（<0.05）。导致大部分形状变化的模式显示，与对照组参与者的髌骨相比，患有PFOA的参与者在髌骨关节部分的背侧隆起相对较厚。其中三个变体与髌骨上骨赘的存在和软骨损伤有关。在髌骨形状与PFOA的临床症状之间发现了多种关联。
髌骨形状与女性中基于MRI的PFOA患病率相关。一些形状变体也与临床症状相关。有趣的是，一种与基于MRI的PFOA存在相关的特定形状变体早些时候在40岁以下人群中被证明与OA相关的结构异常有关。这可能表明髌骨形状可能是PFOA的一个早期可检测的危险因素。
