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Bone morphological factors influencing cartilage degeneration in the knee

Abstract Objectives: Morphological features of the distal femur and proximal tibia associated with cartilage degeneration are unknown. This study aimed to elucidate local anatomical parameters of the knee which correlate with articular cartilage degeneration using MRI T1ρ mapping. Methods: This study involved 200 subjects with knee pain (mean age, 48.7 years; range, 14–80 years) with no severe osteoarthritic changes on plain X-ray. T1ρ values were measured in the regions of interest on the surface layer of the cartilage on mid-coronal images of the femorotibial joint. Assessment of medial and lateral posterior tibial slope (MTS, LTS) and medial and lateral femoral condylar offset ratio (MFCOR, LFCOR) was performed using sagittal proton density-weighted imaging. Morphological assessment of posterior root and horn of menisci was also performed according to a modified Whole Organ Magnetic Resonance Imaging Score (WORMS) of the knee. Results: Multiple regression analysis revealed that a decrease in MTS was associated with increased T1ρ values in the medial tibia, independent of age, osteoarthritic changes on plain X-ray, femur-tibia angle (FTA), and posterior medial meniscal lesions. Conclusions: Shallow MTS correlates with cartilage degeneration in symptomatic patients. This parameter could help in understanding the etiology of osteoarthritis in the early stage. Future kinematic studies will be needed to confirm our findings.