Abstract
IntroductionThe aim of this study was to determine the association between individual quadriceps muscle volumes and the quadriceps enthesis structures and cartilage morphology at the patellofemoral joint (PFJ).MethodsWe studied 12 cadavers (age 75 ± 5 years). For both legs, individual quadriceps muscles (vastus lateralis (VL), rectus femoris (RF), vastus intermedialis (VI) and vastus medialis (VM)) were dissected and their volumes measured. Cartilage areas at the PFJ were classified using the International Cartilage Repair Society (ICRS) score. Histological sections were evaluated at the quadriceps tendon enthesis (laterally, centrally and medially). Several variables were calculated on the binary images based on two-dimensional analysis. These were apparent bone area (BA) and apparent trabecular thickness (TH). A Spearman rank test was used to determine the strength of correlation between individual quadriceps muscles volume, the structure of the quadriceps tendon enthesis and the ICRS score.ResultsThe thickness of calcified fibrocartilage tissue was significantly greater in the central part of the enthesis than both medially (P = 0.03) and laterally (P = 0.04). Uncalcified fibrocartilage was significantly thicker laterally (P = 0.04) and centrally (P = 0.02) than medially. Muscle volume was highest (P <0.05) for the VL, followed by the VI, VM and RF. There was no association between total and individual muscle volumes and ICRS or BA. However, there was a strong positive correlation (r = 0.81) between the VL/VM volume ratio and BA ratio (bone volume at the lateral part divided by bone volume at the medial part). There was a moderate positive correlation between VL/VM and ICRS (r = 0.65) and between ICRS and BA ratio (lateral/medial; r = 0.74).ConclusionsIndividual and total quadriceps volumes were not correlated with cartilage loss at the PFJ or fibrocartilage thickness. However, both VL/VM and BA ratio (lateral/medial) were positively correlated with ICRS scoring and therefore could be a tool for predicting degree of PFJ osteoarthritis severity.
Highlights
The aim of this study was to determine the association between individual quadriceps muscle volumes and the quadriceps enthesis structures and cartilage morphology at the patellofemoral joint (PFJ)
To estimate the amount of load transmitted by each individual quadriceps muscle, we propose to analyze the fibrocartilaginous structure of the quadriceps tendon enthesis at the sites where each individual muscle is attached
The aim of the present study was to investigate the impact of individual quadriceps muscles, and their volume ratios, on the quadriceps tendon enthesis/patella structures and the related association with PFJ OA
Summary
The aim of this study was to determine the association between individual quadriceps muscle volumes and the quadriceps enthesis structures and cartilage morphology at the patellofemoral joint (PFJ). One topic that has been explored our knowledge, there are no data which have reported an association between trabecular bone microarchitecture/ quadriceps enthesis and knee OA. Movement and load are the mechanical stimuli that trigger the metaplasia of fibroblasts to fibrocartilage cells [7]. There is a good correlation between the quantity of uncalcified fibrocartilage at an enthesis and the extent of movement that occurs between tendon/ligament and bone [7]. To estimate the amount of load transmitted by each individual quadriceps muscle, we propose to analyze the fibrocartilaginous structure of the quadriceps tendon enthesis at the sites where each individual muscle is attached
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