Jansen Mylène P, Turmezei Tom D, Dattani Kishan, Kessler Dimitri A, Mastbergen Simon C, Kloppenburg Margreet, Blanco Francisco J, Haugen Ida K, Berenbaum Francis, Wirth Wolfgang, Eckstein Felix, Roemer Frank W, MacKay James W
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Radiology, Norfolk , Norwich University Hospital, Norwich, UK.
Skeletal Radiol. 2025 Mar 21. doi: 10.1007/s00256-025-04907-4.
Cartilage surface mapping is a technique that can visualize 3D cartilage thickness variation throughout a joint without a need for arbitrary regional definitions. The objective of this cross-sectional study was to utilize this technique to evaluate the cartilage thickness distribution in knee osteoarthritis patients and to analyze to what extent it depends on demographic, radiographic, and MRI structural pathology strata.
Patients of the IMI-APPROACH cohort were included, with MRIs obtained at 1.5 T or 3 T. Tibial and femoral cartilage segmentation and registration with a canonical surface were performed semi-automatically. Kellgren-Lawrence and OARSI grading were performed on knee radiographs; MOAKS scoring was performed on MRI scans. The association of demographics and radiographic and MRI scorings with cartilage thickness distribution was analyzed with general linear models using statistical parametric mapping.
Two hundred eighty-seven patients were included. Male sex and height were positively associated with cartilage thickness particularly in the trochlea and medial femur, respectively, with differences up to 0.5 mm (male vs female), while radiographic joint space narrowing and bone marrow lesions showed region-specific negative associations (up to 0.14-0.5 mm per grade). Kellgren-Lawrence grade, MOAKS meniscal extrusion, and osteophytes showed patterns of positive and negative associations, with increasing grades showing reduced local tibiofemoral cartilage thickness, but greater thickness in the trochlea (both up to 0.2-0.3 mm per grade).
Decreased height, female sex, and increasing tibiofemoral pathology were associated with thinner tibiofemoral cartilage. Unexpected results such as consistently thicker cartilage in the anterior femur with increasing disease or osteophytosis states provide opportunities for future research.
软骨表面测绘是一种可在无需任意区域定义的情况下可视化整个关节三维软骨厚度变化的技术。本横断面研究的目的是利用该技术评估膝骨关节炎患者的软骨厚度分布，并分析其在多大程度上取决于人口统计学、影像学和MRI结构病理学分层。
纳入IMI-APPROACH队列的患者，采用1.5T或3T进行MRI检查。胫骨和股骨软骨分割以及与标准表面的配准采用半自动方式进行。对膝关节X线片进行Kellgren-Lawrence和OARSI分级；对MRI扫描进行MOAKS评分。使用统计参数映射的一般线性模型分析人口统计学、影像学和MRI评分与软骨厚度分布之间的关联。
共纳入287例患者。男性和身高分别与软骨厚度呈正相关，尤其分别在滑车和股骨内侧，差异可达0.5mm（男性与女性相比），而影像学关节间隙变窄和骨髓病变显示出区域特异性负相关（每级可达0.14 - 0.5mm）。Kellgren-Lawrence分级、MOAKS半月板挤压和骨赘呈现出正负相关模式，随着分级增加，局部胫股软骨厚度减小，但滑车处厚度增加（两者每级均可达0.2 - 0.3mm）。
身高降低、女性以及胫股病理学改变增加与胫股软骨变薄有关。诸如随着疾病或骨赘形成状态增加股骨前部软骨持续增厚等意外结果为未来研究提供了机会。
