Distal Femoral Cartilage Research Articles

The transepicondylar distance is a reliable and easily measured parameter for estimating femoral cartilage surface area using MRI.

Different cartilage repair techniques are widely used to regenerate cartilage, such as autologous chondrocyte implantation (ACI), osteochondral autograft transfer, microfracturing and minced cartilage. Defect size is a key parameter for selecting the best procedure to repair cartilage. However, the defect's size is not related to the patient's total cartilage surface. This is because assessing the femoral cartilage surface area is time-consuming and therefore unsuitable in the daily clinical routine. It has been proposed that the femur's total cartilage area correlates positively with the transepicondylar distance (TEA). The knees of 40 subjects were analysed. Their average age was 30.1 ± 8.6 years. Twenty-four female and 16 male subjects were examined. Their mean body height was 176.2 ± 8.8 cm. MRI scans were performed via 3-Tesla MRI. These data were postprocessed and quantified using the browser-based, customizable SATORI platform (Fraunhofer MEVIS). This software computed the femoral cartilage surface area (FeCA), the patella cartilage surface area (PCA), the TEA and the patella length. Body height reveals a good correlation (r = 0.722, p < 0.001) with the distal femur's cartilage area surface. However, regression analysis shows only moderate dependence (R2: 0.514). A very good correlation (r = 0.830, p < 0.001) was observed between the TEA distance and the total cartilage surface area of the distal femur. The regression analysis yields a good value (R2: 0.684). The cranio-caudal length of the patella was chosen as a suitably measurable two-dimensional parameter for correlation analysis with the patella's total cartilage surface area. Those results yield a poor correlation (r = 0.577, p < 0.001) between the two parameters, and regression analysis reveals a low value (R2: 0.384). The TEA is a reliable parameter for estimating the femur's cartilage area using MRI. A simple determination of this parameter allows the estimation of the femur's total cartilage area as well as the surface-corrected defect size (SCDS) in daily routine. Level II.

Femoral cartilage thickness measured on MRI varies amongindividuals: Time to deepen one of the principles of kinematic alignment in total knee arthroplasty. A systematic review.

Kinematically aligned total knee arthroplasty (KA TKA), as a pure resurfacing procedure, is based on matching implant thickness with bone cut and kerf thickness, plus cartilage wear. However, the assumption of a consistent 2 mm femoral cartilage thickness remains unproven. This study aimed to systematically review the available literature concerning magnetic resonance imaging (MRI) assessment of femoral cartilage thickness in non-arthritic patients. Our hypothesis was that cartilage thickness values would vary significantly amongindividuals, thereby challenging the established KA paradigm of 'one-cartilage-fits-all'. Systematic literature searches (Pubmed, Scopusand Cochrane Library) followed PRISMA guidelines. English-language studies assessing distal and posterior femoral cartilage thickness using MRI in non-arthritic adults were included. Studies lacking numerical cartilage thickness data, involving post-operative MRI, considering total femoro-tibial cartilage thickness, or failing to specify the compartment of the knee being studied were excluded. Overall, 27 studies comprising 8170 MRIs were analysed. Weighted mean femoral cartilage thicknesses were: 2.05 ± 0.62 mm (mean range 1.06-2.6) for the distal medial condyle, 1.95 ± 0.4 mm (mean range 1.15-2.5) for the distal lateral condyle, 2.44 ± 0.5 mm (mean range 1.37-2.6) for the posterior medial condyleand 2.27 ± 0.38 mm (mean range 1.48-2.5) for the posterior lateral condyle. Femoral cartilage thickness varies significantly across patients. In KA TKA, relying on a fixed thickness of 2 mm may jeopardize the accurate restoration of individual anatomy, leading to errors in implant coronal and rotational alignment. An intraoperative assessment of cartilage thickness may be advisable to express the KA philosophy at its full potential. Level IV.

Increased femoral cartilage thickness in acne patients using isotretinoin: could it be a sign of early osteoarthritis?

Vitamin A derivatives have inhibitory effects on cartilage tissue, such as decreasing chondrocyte proliferation and collagen synthesis, and increasing the loss of glycosaminoglycans and proteoglycans. Therefore, isotretinoin (a vitamin A derivative) may play a role in the pathogenesis of cartilage-related diseases like osteoarthritis by affecting the balance of cartilage tissue. The aim of this study was to evaluate the distal femoral cartilage thickness in acne patients under the systemic isotretinoin therapy and to determine whether it constitutes a risk factor for the development of osteoarthritis. The study included 52 patients (42 female, 10 male, mean age 23.31 ± 3.89 years) who were prescribed systemic isotretinoin for acne and completed at least 3 months of treatment, along with 45 healthy controls ((35 female, 10 male, mean age 23.85 ± 4.77 years). Bilateral distal femoral cartilage thickness was measured by ultrasonography before isotretinoin treatment and after the completion of the third month of treatment. After treatment, a statistically significant increase was found in the thickness of the right medial, right lateral, left medial, left lateral, and left intercondylar cartilage (p = 0.014, 0.012, 0.019, 0.027, 0.002, respectively). There was also an increase in the right intercondylar cartilage thickness, but this was not statistically significant (p = 0.1). Systemic isotretinoin seems to make cartilage thicker. The increase in femoral cartilage thickness observed after short-term isotretinoin treatment might be an indicator of very early-stage osteoarthritis. Extended follow-up studies with larger participant pools are necessary to substantiate this result.

Impact of treadmill running on distal femoral cartilage thickness: a cross-sectional study of professional athletes and healthy controls

PurposeThis present study aimed to assess the impact of treadmill running on distal femoral cartilage thickness.MethodsProfessional athletes aged 20 to 40 years with a history of treadmill running (minimum 75 min per week for the past three months or more) and age-, sex-, and body mass index (BMI)-matched healthy controls were recruited. Demographics and clinical features of participants were recorded. Athletes were divided into subgroup 1 with less than 12 months of treadmill running and subgroup 2 with 12 months or more of treadmill running. Distal femoral cartilage thicknesses were measured at the midpoints of the right medial condyle (RMC), right intercondylar area (RIA), right lateral condyle (RLC), left medial condyle (LMC), left intercondylar area (LIA), and left lateral condyle (LLC) via ultrasonography.ResultA total of 72 athletes (mean age: 29.6 ± 6.6 years) and 72 controls (mean age: 31.9 ± 6.7 years) were enrolled. Athletes had significantly thinner cartilages in the RLC (2.21 ± 0.38 vs. 2.39 ± 0.31 cm, p = 0.002), LLC (2.28 ± 0.37 vs. 2.46 ± 0.35 cm, p = 0.004), and LMC (2.28 ± 0.42 vs. 2.42 ± 0.36 cm, p = 0.039) compared with the control group. Furthermore, cartilage thickness was significantly thinner in subgroup 2 athletes compared with the control group in the RLC (2.13 ± 0.34 vs. 2.39 ± 0.31 cm, p = 0.001), LLC (2.22 ± 0.31 vs. 2.46 ± 0.35 cm, p = 0.005), and LMC (2.21 ± 0.46 vs. 2.42 ± 0.36 cm, p = 0.027); however, subgroup 1 athletes did not have such differences. There was a weak negative correlation between total months of treadmill running and cartilage thickness in the RLC (r = − 0.0236, p = 0.046) and LLC (r = − 0.0233, p = 0.049). No significant correlation was found between the distal femoral cartilage thickness at different sites and the patients’ demographic features, including age, BMI, speed and incline of treadmill running, and minutes of running per session and week (p > 0.05).ConclusionCompared with healthy controls, professional athletes with a history of long-term high-intensity treadmill running had thinner femoral cartilages. The duration (months) of treadmill running was weakly negatively correlated with distal femoral cartilage thickness. Longitudinal studies with prolonged follow-ups are needed to clarify how treadmill running affects femoral cartilage thickness in athletes.

Is seborrheic dermatitis associated with early-stage osteoarthritis?

Seborrheic dermatitis (SD) and osteoarthritis involve similar factors in their pathogenesis. Both of these diseases are associated with an increased frequency of metabolic syndrome and underlying systemic inflammation. This study evaluated the thickness of the distal femoral cartilage using ultrasonography in patients with SD. The study enrolled 60 patients with SD (19 females and 41 males, mean age: 34.07 ± 12.56 years) and 60 controls matched for age and sex (20 females and 40 males, mean age: 35.08 ± 12.78 years). Ultrasonography was used to measure the distal femoral cartilage thickness (FCT) of the right medial condyle, right lateral condyle, right intercondylar area, left medial condyle, left lateral condyle, and left intercondylar area. FCT values at all points were significantly higher in patients with SD than in the controls (P < .05). Further, all FCT values were significantly higher in patients with moderate SD than in those with mild SD (P < .001). A strong positive correlation was observed between disease severity and FCT measured at right medial condyle (r = .7, P < .001), right lateral condyle (r = .749, P < .001), right intercondylar area (r = .79, P < .001), left medial condyle (r = .624, P < .001), and left intercondylar area (r = .703, P < .001). Further, a moderately positive correlation was observed between disease severity and FCT measured at left lateral condyle (r = .581, P < .001). Increased FCT in patients with SD might be an early indicator of osteoarthritis. However, further studies, especially those evaluating older patients with SD, are required to support our findings.

Measurement Position Influences Sex Comparisons of Distal Femoral Cartilage Thickness With Ultrasound Imaging.

The purpose was to examine (1)the effect of measurement position and sex on femoral cartilage outcomes, and (2)the association between gait biomechanics and cartilage outcomes. Fifty individuals participated (25 males and 25 females; age = 20.62 [1.80]y). Ultrasound measured femoral cartilage thickness and echo-intensity at 90°, 115°, and 140° of knee flexion. Gait outcomes included the external knee adduction and knee flexion moments. Cartilage outcomes were compared using 2 (sex) × 3 (position) repeated-measures analysis of variance. Gait and cartilage associations were assessed using stepwise regression. Medial cartilage was thicker when measured at 90° compared with 115° (P = .02) and 140° (P < .01), and 115° compared with 140°, (P < .01) in males but not in females. Cartilage was thicker at 90° compared with 140° across both sexes within all regions (P < .01). Males had thicker cartilage than females in all positions (P < .01). Echo-intensity was lower at 90° than 115° (P < .01) and 140° (P = .01) in the central and lower at 90° than at 115° (P < .01) and 140° (P = .03) in lateral regions. No association was found between gait and cartilage outcomes. Ultrasound imaging position effects cartilage features more in males compared with females. Imaging position and sex influence cartilage outcomes and should be considered in study designs and clinical evaluation.

THE IMPACT OF PREGNANCY ON DISTAL FEMORAL CARTILAGE- A PROSPECTIVE COHORT STUDY

Aim: Cartilage destruction has been associated with many factors such as overweight, excessive use of joints and forced movements, abrasion due to the aging process, and genetic factors. Obesity is a modifiable risk factor for osteoarthritis. This study aimed to determine the thickness of knee joint cartilage and demonstrate the impact of the pregnancy process on osteoarthritis development during pregnancy.&#x0D; Matherial and Method: Fifty pregnant women aged 15-42 years, were included in this study. The ultrasound image of dominant knee distal femoral cartilage was measured at the 1st and 3rd trimesters in the lateral condyle, intercondylar area, and medial condyle from the strong anechoic area between the bone cortex and the suprapatellar fat pad.&#x0D; Results: We found that the third trimester cartilage measurements for each of the nulliparous and multiparous pregnant women were significantly thinner than the first trimester cartilage measurements (p=0.001, p=0.005, p

MRI T2 mapping and quantitative ultrasound shear wave elastography in cartilage integrity assessment for juvenile idiopathic arthritis patients

BackgroundJuvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood that can lead to irreversible cartilage damage, with associated disability and decreased life quality. Shear wave elastography and quantitative MRI mapping can be used to identify early cartilage affection. PurposeTo evaluate diagnostic utility of distal femoral cartilage shear wave elastography and MRI T2 mapping in patients with symptomatic knee and investigate their potential clinical significance.Material and methodsTwenty patients with knee affection (study group) and 20 volunteers with the same demographic characteristics but without symptomatic knee pain (control group) were included in the study. A total of 80 knee joints of 40 individuals were evaluated. At the medial, intercondylar, and lateral condylar levels, distal femoral cartilage thickness was measured by B-mode ultrasonography and MRI, stiffness was assessed by shear wave elastography, and T2 relaxation time was measured by MRI.ResultsThe medial, intercondylar, and lateral cartilage thickness measurements were similar between the two groups and no statistically significant difference was observed while measured by US (P value 0.653,0.702,0.607) and MRI (P value 0.414, 0.4187, 0.3903). The shear wave velocity values in the study group were significantly higher than in the control group (P value 0.0202). There was a statistically significant difference between the average T2 relaxation time values for the distal femoral cartilage in the study and the control groups (P value 0.0027). SWE results were statistically significant in moderate and high disease activity while T2* revealed statistically significant p values in low as well as moderate and high disease activity; we found the best cutoff values for detection of cases using shear wave elastography velocity ratio (m/sec) about 4.445 with significant p value = 0.02, sensitivity 59.3% and specificity = 70.45%.ConclusionShear wave elastography and MRI T2 mapping are reliable, non-invasive, and acceptable methods for the assessment of pathologic cartilage. Better diagnostic information of hyaline cartilage can be obtained by adding up an extra sequence called T2 mapping to the routine MRI protocol of knee.

Characteristics of distal femoral articular cartilage in 6 weeks posttraumatic osteoarthritis by a subcritical impact.

Traumatized knee greatly contributes to osteoarthritis (OA) of the knee in young adults. To intervene effectively before the onset of severe structural disruption, detection of the disease at the early onset is crucial. In this study, we put together the findings for the detection of OA from the femoral knee joint cartilage of the rabbit at 6 weeks posttrauma. Articular cartilage samples are taken from the impacted and nonimpacted joints at 0 week (serving as the control group) and at 6 weeks posttrauma by minimal force. The samples were imaged using microscopic magnetic resonance imaging (µMRI) at 11.7 µm/pixel and polarized light microscopy (PLM) at 1 µm/pixel. In addition, an inductively coupled plasma - optical emission spectrometry analysis was performed using the adjacent cartilage samples. The outcomes of this study demonstrate an increase in T2 values in 6 weeks samples compared to the 0 week samples by µMRI technique, indicating a general increase of tissue hydration within cartilage. PLM detects a decrease in the average thickness of the superficial zones in the posttraumatic osteoarthritis samples, significant in the impacted femurs. There was an average increasing trend of maximum retardation in the tide mark in comparison to the reported calcium concentration (mg/L) in impacted samples suggesting a possible rise in mineralization in the 6 weeks samples. Qualitatively, physical observation of the joint after 6 weeks showed signs of reddening in the anterior femur suggesting the disease process is a localized phenomenon. Through microscopic imaging, we are able to detect these changes at 6 weeks posttrauma qualitatively and quantitatively.

Posterior Proximal Cartilage of the Lateral Femoral Condyle as a Reference for Positioning the Femoral Tunnel in ACL Reconstruction

Background: Due to the similarity among specimens in the height of the anterior cruciate ligament (ACL) on the distal proximal axis in relation to the proximal posterior cartilage of the lateral femoral condyle (point C), it is known this point can be used as an arthroscopic intraoperative parameter to define the position of the femoral tunnel in ACL reconstruction. Indications: For ACL reconstruction, point C can be used as an arthroscopic intraoperative parameter to define the position of the femoral tunnel on the distal proximal and anteroposterior axes. Technique Description: For access to the joint, standard arthroscopic ports, both anterolateral (AL) and anteromedial (AM), are used. By directing the camera toward the posterior region of the lateral femoral condyle through the AM port, it is possible to visualize the end of the posterior and proximal articular cartilage, the so-called C point. In this case, we sought to position the center of the femoral tunnel in the center of the AM band of the ACL. Holding the camera through the AM portal and visualizing point C, a millimeter-scale femoral guide is introduced through the AL portal toward the posterior femoral cartilage (point C) and positioned over it, creating a line between point C and the lateral distal femoral cartilage. The distance between point C and the distal femoral cartilage is measured. At this time, an accessory AM portal 1.5 cm from the AM port is constructed. Through it, with the aid of an ice pick or radiofrequency tip, a marking is made in the deep to shallow axis at 35% of this distance. Then, approximately 2 mm above the imaginary line formed by the union of point C and the lateral distal femoral cartilage, the center of the femoral tunnel is marked. Results: Point C is an anatomical landmark that is easy to view and is present in all knees; thus, it can be used as a reference during surgery for positioning the femoral tunnel. Discussion/Conclusion: Point C can be used as an arthroscopic intraoperative parameter to define the position of the femoral tunnel in ACL reconstruction. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

The effect ofintra-articular steroid injection onthe cartilage andtendon thicknesses injuvenile idiopathic arthritis.

Intra-articular corticosteroid injection (IACI) is a safe first-line or adjunct therapy used in any subtype of juvenile idiopathic arthritis (JIA). Limited studies evaluated the effect of IACI on cartilage. Our study aimed to examine the femoral cartilage thickness of patients with JIA who received IACI to the knee joint using ultrasound. We randomly selected JIA patients who performed IACI in the knee joint. Baseline bilateral joint cartilage and tendon thicknesses were measured. The articular fluid was aspirated, and applied IACI at the same period. Six months after injection, the exact measurements were repeated. Distal femoral cartilage, quadriceps tendon, and distal and proximal patellar tendon thicknesses were compared at the baseline (before IACI) and 6 months after IACI. Thirty patients with JIA were included, and 23 (76.7%) were female. The median age was 11 years (interquartile range, 6 to 14), and the median disease duration was 3.3 years (interquartile range, 5 months to 5 years). The subtypes of JIA were oligoarticular in 25 (83.3%), polyarticular in 2 (6.7%), enthesitis-related arthritis in 2 (6.7%), and juvenile psoriatic arthritis in 1 (3.3%). Distal femoral cartilage thickness was 2.96 ± 0.79 mm at baseline and 2.85 ± 0.70 mm at 6 months after IACI (P = .35). The tendon thicknesses were similar at 6 months after baseline measurements. Our findings reveal that knee IACI in patients with JIA did not significantly change cartilage and tendon thicknesses. This observation could indicate that IACIs have no detrimental effects on the cartilage and the tendons.

Ultrasonographic assessment of knee joint in patients with diabetes mellitus: comparison of sonographic changes in distal femoral cartilage and tendon structures with non-diabetics patients.

The aim of this study was to evaluate the adverse effects of diabetes mellitus on the knee joint by using ultrasonography. One hundred and two subjects with diabetes for 5 years and more were compared prospectively with 93 age and sex-matched healthy subjects. Individuals in both groups were aged between 40-55, had a body mass index below 30 kg/m2, and had no knee joint complaints. Femoral cartilage thickness, cartilage surface, quadriceps and patellar tendon thickness in both knees were assessed by ultrasonography using a 5-12 mHz linear transducer. According to ultrasonographic findings, thin and irregular femoral cartilage was more common in diabetic patients than in healthy controls (p<0.05). Diabetic patients had thinner quadriceps tendons compared to the control group (p<0.001). No statistically significant difference was recorded in patellar tendon thickness (right knee p=0.697, left knee p=0.639). The presence of effusion in the suprapatellar recess of the right knee was more common in diabetics than non-diabetics (p=0.006). Irregularity and thinning of the distal femoral cartilage in diabetics may indicate cartilage degeneration. In addition, the decrease in the thickness of the quadriceps tendon may lead to instability and adversely affect the knee joint. These sonographic findings may indicate early knee joint degeneration, so ultrasonography may help determine the possible risk of osteoarthritis in diabetic patients.

The AIUM Practice Parameter for the Performance of the Musculoskeletal Ultrasound Examination.

The AIUM Practice Parameter for the Performance of the Musculoskeletal Ultrasound Examination.

Exoskeleton-Assisted Walking for Pulmonary and Exercise Performances of SCI Individuals.

To determine whether exoskeleton-assisted walking (EAW) improves pulmonary ventilation function, motor function and related body structure, and activities equivalently as the conventional exercise program for people with spinal cord injury (SCI). Forty participants (7 females and 33 males; age 37.1±12.0 years) with thoracic SCI were randomized into two groups and undertook 16 sessions of 50-60 min training (4 days/week). Participants in the EAW group received EAW trainings, such as assisted standing, walking, and climbing the stairs. The control group received a conventional exercise program. Outcomes were measured at baseline and upon completion of treatment. After trainings, the EAW group improved more than the control group in the forced vital capacity (FVC, 0.53 L [0.01-1.06 L]), predicted FVC% (19.59 [6.63-32.54]) and forced expiratory volume in 1s (0.61 L [0.15-1.07 L]), basic activities of daily living (BADL) (19.75 [10.88-28.62]), and distal femoral cartilage. Participants in the EAW group completed 6-minute walk test with median 17.3 meters while wearing the exoskeleton. There was no difference in trunk and lower extremity motor function, bone mineral density, and adverse events ( P > 0.05). In people with lower thoracic neurological level of SCI, EAW training has potential benefits to facilitate pulmonary ventilation function, walking, BADL and thickness of cartilage comparing to a conventional excise program. This study provided more evidence for using EAW in clinic, and partly proved EAW had equivalent effects as conventional exercise program, which may combine with conventional exercise program for reducing burden of therapists in the future.

The effect of ferritin levels on distal femoral cartilage thickness in patients with beta thalassaemia major.

To the best of our knowledge, the present study is the first in the literature to assess distal femoral cartilage thickness and its relationship with ferritin levels in adult patients with beta thalassaemia major (BTM). 45 patients with BTM and 45 healthy controls were included in the study. Ferritin and haemoglobin levels of the patient and healthy groups were determined by blood analysis and distal femoral cartilage thicknesses were measured via ultrasound. Then, the patient group was divided into subgroups according to whether their ferritin levels were below or above 2500µg/L. They were then compared among themselves and with the healthy control group using the available data. Distal femoral cartilage thickness values were statistically significantly lower in the BTM group compared to the healthy control group (p values < 0.001). Patients with a ferritin level below 2500µg/L had statistically significantly higher right and left average distal femoral cartilage thickness values than the patients with a ferritin level above 2500µg/L (p = 0.029 and p = 0.019, respectively). The right and left average distal femoral cartilage thickness values of the patient subgroup with low ferritin levels were statistically similar to the control group (p = 0.146 and p = 0.164, respectively). Our study showed that thalassaemia patients are more likely to develop osteoarthritis (OA) than the normal population and possible OA development can be prevented by keeping the ferritin levels of these patients in the optimum range.

Ultrasound assessment of distal femoral cartilage thickness measurements after walking/jogging in subjects with pes planus

BackgroundBecause there is a closed kinematic chain between the lower extremity joints during weight-bearing activities, pes planus can affect knee biomechanics. ObjectiveThis study aimed to measure distal femoral cartilage thickness with ultrasound after 3 different conditions (at rest, during walking and jogging) in subjects with pes planus and compare these conditions with each other and also with controls. MethodSixteen participants with pes planus(5-men, 11-women; aged 18–30 years) and 16 controls(3-men, 13-women; aged 18–30 years) were enrolled. Distal femoral cartilage thickness was evaluated with ultrasound before and after three separate 30-min conditions. Preferred walking speed (PWS) was determined on the ground. Subjects walked on a treadmill for 30-min at their PWS and jogged 30-min at 30% above their PWS. The Foot Function Index and the Foot-Ankle Outcome Survey were used to evaluate the clinical and functional status of the subjects. ResultsNeither PWSs nor jogging speeds were statistically different between groups (p > 0.05). There were no statistically significant differences between groups for absolute and percent change of cartilage thickness for all three conditions (p > 0.05). There were also no statistically significant differences between conditions for each intragroup (p > 0.05). The median Foot Function Index score of the subjects with pes planus was 9.78(0–44.35) for the right foot and 9.52(0–40.87) for the left foot. The median the Foot-Ankle Outcome Survey score of the subjects with pes planus was 88(65–100). ConclusionThere was no difference in knee joint cartilage deformations under different loading conditions, neither in subjects with pes planus nor in controls.

Ultrasonographic evaluation of distal femoral and talar cartilage thicknesses in patients with early rheumatoid arthritis and their relationship with disease activity.

The aims of this study were to compare the distal femoral and talar cartilage thicknesses by ultrasonography (US) between patients with early rheumatoid arthritis (RA) and healthy controls and to investigate the potential relationship of these parameters with disease activity and clinical parameters. Fifty-five patients with RA with a disease duration of up to 12 months (RA group), and 55 healthy volunteers (control group) were included in the study. The bilateral distal femur and talus cartilage thicknesses of all participants were measured by US and compared between the groups. The relationship of the results with the clinical data of the patients with early RA was investigated. The distal femur (medial, central, and lateral) and talus cartilage thicknesses of both extremities were significantly lower in the RA group. The tender joint count was found to be slightly to moderately negatively correlated with cartilage thickness. However, no correlation was found between the swollen joint count and cartilage thickness. In addition, the disease activity scores were moderately and inversely correlated with cartilage thickness in certain areas. The results of this preliminary study using US indicate that the distal femoral and talus cartilage of patients with RA can be affected in the early period, and the cartilage thickness of patients seems to be associated with disease activity. These results may inspire new studies for the evaluation of femoral and talar cartilage with US. Key Points • The distal femoral and talus cartilage thicknesses seem to be affected in the early period of rheumatoid arthritis. • There may be a relationship between the distal femur and talus cartilage thicknesses and disease activity in patients with early rheumatoid arthritis. • The tender joint count appears to be more associated with cartilage thickness than the swollen joint count in patients with early rheumatoid arthritis.

The Presence of Cartilage Affects Femoral Rotational Alignment in Total Knee Arthroplasty.

ObjectiveTo assess the difference between the posterior condylar angle (PCA) and the mechanical lateral distal femoral angle (mLDFA) in the osseous and cartilaginous contours in a non-arthritic Chinese population.MethodsComputed tomography (CT) and magnetic resonance imaging (MRI) were obtained from 83 patients with knee injuries before arthroscopy, and femur and distal femoral cartilage three-dimensional (3D) models were constructed. The 3D cartilage model was arranged to share physical space with the 3D femoral model, and then PCA and mLDFA were measured on the osseous and cartilaginous contours, respectively. The differences between the measurements with and without cartilage were evaluated.ResultsThe average PCA with cartilage was 2.88 ± 1.35° and without was 2.73 ± 1.34°. The difference was significant in all patients and females but not in males. The average mLDFA with cartilage was 84.73 ± 2.15° and without cartilage was 84.83 ± 2.26°, but the difference was statistically insignificant in all groups.ConclusionPCA on the osseous and cartilaginous contours significantly differed with and without cartilage in the female group, suggesting that cartilage thickness should be considered during preoperative femoral rotational resection planning.

Quantifying Region-Specific Elastic Properties of Distal Femoral Articular Cartilage: A Shear-Wave Elastography Study.

Knee osteoarthritis is a disease with the degeneration of articular cartilage as its main feature. Cartilage thickness cannot become a single index to evaluate cartilage degeneration, so it is essential to also evaluate the stiffness. The purposes were as follows: (1) to examine test-retest reliabilities of the elastic modulus measurement in distal femoral articular cartilage (FAC) and compare the changes in specific-regional of distal FAC, (2) to explore the difference in distal FAC stiffness and thickness between the dominant and nondominant sides, and (3) to examine the correlation between the elastic properties of cartilage and the thickness of cartilage. Twenty healthy participants were recruited. The stiffness of distal FAC at the lateral femoral condyle (LFC), medial femoral condyle (MFC), and intercondylar notch (IN) was quantified using shear-wave elastography (SWE). Intra- and interrater reliabilities were excellent for measuring the stiffness of distal FAC (ICC: 0.83-0.98). About a 50% increase in the stiffness of LFC (40.78 kPa) was found when compared with IN (21.82 kPa) and MFC (18.34 kPa). No significant difference was found between the dominant and nondominant sides in distal FAC stiffness and thickness. There was no correlation between the stiffness and thickness of the distal FAC. In conclusion, SWE can quantify the stiffness of the distal FAC.

T2 Relaxation Time Changes in the Distal Femoral Condylar Cartilage of Children and Young Adults with Discoid Meniscus.

ObjectiveTo investigate compositional changes in the distal femoral condylar cartilage (FCC) of children and young adults with and without discoid meniscus by T2 relaxation time mapping.DesignWe retrospectively reviewed knee magnetic resonance images including sagittal T2 maps of distal FCC performed in patients with or without discoid meniscus. Combined meniscal pathology such as degeneration or tears was also reviewed. Regions of interest were selected, and T2 relaxation time profiles were generated according to medial and lateral and FCC and according to weight-bearing and non-weight-bearing FCC. Nonparametric comparison tests using median values were performed.ResultsSeventy-nine knees from 73 patients (2-20 years) including 45 knees with lateral discoid meniscus (discoid group) were studied. T2 values of FCC showed negative correlation with age in both the discoid and nondiscoid groups (P < 0.01), except for medial weight-bearing FCC. In the discoid group, T2 relaxation times of lateral weight-bearing FCC (median, 46.5 ms) were lower than those of lateral non-weight-bearing (median, 53.2 ms; P < 0.001) and medial weight-bearing (median, 50.5 ms; P = 0.012) FCC. Lateral weight-bearing FCC also showed lower T2 values than other areas in patients with meniscal pathology in the discoid group. However, T2 relaxation times did not differ between the discoid and nondiscoid groups in patients without meniscal pathology.ConclusionsChildren and young adults with discoid meniscus have lower T2 relaxation times in lateral weight-bearing FCC compared with non-weight-bearing or medial FCC, suggesting compositional changes have occurred in these patients.