Park Nancy, Sieberer Johannes M, McGinley Brooke, Manafzadeh Armita R, Lynch John, Segal Neil A, Lewis Cora E, Guermazi Ali, Roemer Frank W, Stefanik Joshua, Felson David T, Fulkerson John P
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.
Department of Mechanical Engineering, Yale School of Engineering and Applied Science, New Haven, Connecticut, USA.
Am J Sports Med. 2025 Sep 12:3635465251367716. doi: 10.1177/03635465251367716.
The relationship between patellofemoral (PF) morphology and PF cartilage damage in the general population remains unclear.
This study aimed to determine whether 3-dimensional-based metrics of PF morphology are associated with progressive lateral PF cartilage damage.
Cross-sectional study; Level of evidence, 2.
We analyzed nonweightbearing computed tomography scans of knees from a subset of participants enrolled in the community-based Multicenter Osteoarthritis Study. Baseline and 2-year magnetic resonance imaging scans of the knee were evaluated for progressive PF cartilage damage using the Magnetic Resonance Imaging Osteoarthritis Knee Score. Tibial tubercle-trochlear groove (TT-TG) distance, patellar tilt, external tibiofemoral rotation (eTFR), patellar height, entry point-trochlear groove angle, and entry point-transition point (EP-TP) angle were measured for each knee. To assess the association of each morphology measure with progressive cartilage damage, logistic regression models with generalized estimating equations were fit using continuous and natural cubic spline models.
We analyzed lateral PF cartilage damage in 389 knees (mean age, 53.79 ± 5.51 years; mean body mass index, 28.48 ± 5.13 kg/m). TT-TG distance (β = 0.23; odds ratio, 1.26; = .036), eTFR (β = 0.24; odds ratio, 1.27; = .048), and EP-TP angle ( = 2.09; = .036) all demonstrated significant positive associations with worsening lateral PF cartilage damage.
The results demonstrated significant associations between 3-dimensional anatomic metrics and progressive lateral PF cartilage damage. Elevated TT-TG distance, eTFR, and EP-TP angle may be keys to understanding the mechanical cause of lateral PF osteoarthritis.
在普通人群中，髌股关节（PF）形态与PF软骨损伤之间的关系仍不明确。
本研究旨在确定基于三维的PF形态指标是否与PF外侧软骨的进行性损伤相关。
横断面研究；证据等级，2级。
我们分析了参与社区多中心骨关节炎研究的部分参与者膝关节的非负重计算机断层扫描。使用膝关节磁共振成像骨关节炎评分，对膝关节的基线和2年磁共振成像扫描进行评估，以确定PF软骨的进行性损伤情况。测量每个膝关节的胫骨结节-滑车沟（TT-TG）距离、髌骨倾斜度、胫股外旋（eTFR）、髌骨高度、入点-滑车沟角度和入点-过渡点（EP-TP）角度。为了评估每种形态学测量与软骨进行性损伤之间的关联，使用连续和自然立方样条模型拟合带有广义估计方程的逻辑回归模型。
我们分析了389个膝关节的PF外侧软骨损伤情况（平均年龄，53.79±5.51岁；平均体重指数，28.48±5.13kg/m²）。TT-TG距离（β = 0.23；比值比，1.26；P = 0.036）、eTFR（β = 0.24；比值比，1.27；P = 0.048）和EP-TP角度（β = 2.09；P = 0.036）均与PF外侧软骨损伤加重呈显著正相关。
结果表明三维解剖指标与PF外侧软骨的进行性损伤之间存在显著关联。TT-TG距离增加、eTFR增加和EP-TP角度增大可能是理解PF外侧骨关节炎机械病因的关键。
