Department Orthopaedics and Sports Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department General Practice, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Orthop Res. 2024 Jan;42(1):78-89. doi: 10.1002/jor.25640. Epub 2023 Jun 21.
In this cross-sectional study, we compared patellofemoral geometry in individuals with a youth-sport-related intra-articular knee injury to uninjured individuals, and the association between patellofemoral geometry and magnetic resonance imaging (MRI)-defined osteoarthritis (OA) features. In the Youth Prevention of Early OA (PrE-OA) cohort, we assessed 10 patellofemoral geometry measures in individuals 3-10 years following injury compared with uninjured individuals of similar age, sex, and sport, using mixed effects linear regression. We also dichotomized geometry to identify extreme (>1.96 standard deviations) features and assessed likelihood of having extreme values using Poisson regression. Finally, we evaluated the associations between patellofemoral geometry with MRI-defined OA features using restricted cubic spline regression. Mean patellofemoral geometry did not differ substantially between groups. However, compared with uninjured individuals, injured individuals were more likely to have extremely large sulcus angle (prevalence ratio [PR] 3.9 [95% confidence interval, CI: 2.3, 6.6]), and shallow lateral trochlear inclination (PR 4.3 (1.1, 17.9)) and trochlear depth (PR 5.3 (1.6, 17.4)). In both groups, high bisect offset (PR 1.7 [1.3, 2.1]) and sulcus angle (PR 4.0 [2.3, 7.0]) were associated with cartilage lesion, and most geometry measures were associated with at least one structural feature, especially cartilage lesions and osteophytes. We observed no interaction between geometry and injury. Certain patellofemoral geometry features are correlated with higher prevalence of structural lesions compared with injury alone, 3-10 years following knee injury. Hypotheses generated in this study, once further evaluated, could contribute to identifying higher-risk individuals who may benefit from targeted treatment aimed at preventing posttraumatic OA.
在这项横断面研究中，我们比较了与青少年运动相关的膝关节内损伤患者与未受伤患者的髌股关节几何形状，并比较了髌股关节几何形状与磁共振成像（MRI）定义的骨关节炎（OA）特征之间的关系。在青少年预防早期 OA（PrE-OA）队列中，我们使用混合效应线性回归比较了 10 项髌股关节几何形状指标，比较了损伤后 3-10 年的患者与年龄、性别和运动相似的未受伤患者。我们还将几何形状进行了二分法，以确定极端（>1.96 个标准差）特征，并使用泊松回归评估出现极端值的可能性。最后，我们使用限制性立方样条回归评估了髌股关节几何形状与 MRI 定义的 OA 特征之间的相关性。两组之间的髌股关节几何形状没有明显差异。然而，与未受伤者相比，受伤者更有可能出现极度增大的滑车沟角（优势比[PR]3.9[95%置信区间，CI：2.3，6.6]）和浅外侧滑车倾斜度（PR 4.3[1.1，17.9]）和滑车深度（PR 5.3[1.6，17.4]）。在两组中，高位髌骨偏移量（PR 1.7[1.3，2.1]）和滑车沟角（PR 4.0[2.3，7.0]）与软骨病变相关，大多数几何形状指标与至少一种结构特征相关，尤其是软骨病变和骨赘。我们没有观察到几何形状和损伤之间的相互作用。与单独的损伤相比，某些髌股关节几何形状特征与结构病变的更高患病率相关，在膝关节损伤后 3-10 年。本研究提出的假设，一旦进一步评估，可能有助于确定可能受益于针对创伤后 OA 的靶向治疗的高危人群。
