Relationship between alignment and cartilage thickness in patients with non-traumatic and post-traumatic knee osteoarthritis

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To compare cartilage thickness between patients with non-traumatic and post-traumatic knee osteoarthritis (OA) and healthy controls and to determine if disease severity and alignment impact these differences. Participants with non-traumatic (n=22) and post-traumatic (n=19) knee OA, and healthy controls (n=22) were recruited for this cross-sectional study. Participants underwent 3T magnetic resonance imaging (T1-weighted, 3D sagittal gradient echo sequence) and cartilage thickness was determined in four regions: medial and lateral condyle, and medial and lateral plateau. Lower extremity alignment (mechanical axis angle) and disease severity (Kellgren-Lawrence scores) were measured from full length radiographs. Statistical analysis included one-way analysis of variance (ANOVA) and modified Bonferroni test adjusting for multiple pairwise comparisons. Linear regression analyses examined the relationship between cartilage thickness and knee OA group after controlling for disease severity, meniscal status, and alignment. In participants with predominantly medial compartment knee OA, compared to healthy controls, those with non-traumatic knee OA had diminished cartilage thickness in the medial plateau (p=0.035) and those with post-traumatic knee OA had greater cartilage thickness in the lateral condyle (p=0.044). In the lateral condyle, data revealed that alignment accounted for the variance in cartilage thickness (p=0.035), in which a stronger relationship was found in the non-traumatic (r=-0.61) than the post-traumatic (r=-0.12) OA group. Emerging data demonstrated that participants with non-traumatic knee OA have a stronger relationship between alignment and cartilage thickness than those with post-traumatic knee OA. This indicates that factors involved in knee OA initiation and progression may differ between these OA subtypes.