Abstract
Background/aimEvaluating the relationship of patellar chondromalacia with obesity, infrapatellar fat pad (IFP) volume and popliteal artery intima-media thickness (IMT).Materials and methodsA total of 203 patients with different degree of patellar chondromalacia (103 male, 100 female) and 52 control subjects (19 male, 33 female) were included and grouped according to sex, age, body surface area (BSA), body mass index (BMI) and patellar chondromalacia classification. All measurements were completed with 3T magnetic resonance imaging (MRI). Articular cartilage and IFP volume were measured in saggital plane using double echo steady state (DESS) and DIXON sequences, respectively. Patellar cartilage damage was graded using modified outerbridge classification, and the relations among cartilage volume and BMI, BSA, IFP, IMT were statistically assessed.ResultsPopliteal artery IMT showed an independent association with the prevalence of cartilage defects and IFP volumes (P ˂ 0.001). There was an association between BMI and IFP volumes (P ˂ 0.001). However, no differences were observed between IFP volume and different chondromalacia groups. When IFP measurements were corrected using individual BMI and BSA values, a positive correlation was found between control and advanced chondromalacia groups (P ˂ 0.001).ConclusionThis study demonstrates the relationship among obesity, IMT and chondromalacia and highlights this potential circle to develop effective treatments and inhibit the progression of chondromalacia.
Highlights
Degenerative joint disorders like patellofemoral arthritis are leading causes of morbidity and economic loss, and have a significant impact on community health in the adult population
Popliteal artery intima-media thickness (IMT) showed an independent association with the prevalence of cartilage defects and infrapatellar fat pad (IFP) volumes (P 0.001)
When IFP measurements were corrected using individual body mass index (BMI) and body surface area (BSA) values, a positive correlation was found between control and advanced chondromalacia groups (P 0.001)
Summary
Degenerative joint disorders like patellofemoral arthritis are leading causes of morbidity and economic loss, and have a significant impact on community health in the adult population. In addition to biomechanical causes, a multifactorial interaction based on specific roles of some inflammatory and vascular causes has been suggested in the etiology, with particular focus in recent years being on infrapatellar fat tissue and vascular wall changes [1,2]. There have been a limited number of studies to date, reporting increased infrapatellar fat tissue volume, and a correlation between body mass index (BMI) and infrapatellar fat tissue volume in patients with osteoarthritis (OA) [3]. Recent studies into the physiology of fat tissue have suggested that destruction of the joint cartilage seen in overweight people may be associated with some systemic factors, aside from mechanical load. Studies have indicated that the infrapatellar fat pad (IFP) releases inflammatory mediators, and plays a significant role in the onset and progression of OA [3,7]
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