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Azami P, Ashraf A, Yousefi O, Hosseinpour A, Nasiri A. Impact of treadmill running on distal femoral cartilage thickness: a cross-sectional study of professional athletes and healthy controls. BMC Sports Sci Med Rehabil 2024; 16:104. [PMID: 38711058 DOI: 10.1186/s13102-024-00896-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 05/02/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE This present study aimed to assess the impact of treadmill running on distal femoral cartilage thickness. METHODS Professional 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. RESULT A 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). CONCLUSION Compared 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.
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Affiliation(s)
- Pouria Azami
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Ashraf
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Yousefi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Aref Nasiri
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran.
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Huang F, Harris S, Zhou T, Roby GB, Preston B, Rivière C. Which method for femoral component sizing when performing kinematic alignment TKA? An in silico study. Orthop Traumatol Surg Res 2024; 110:103769. [PMID: 37979678 DOI: 10.1016/j.otsr.2023.103769] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/01/2023] [Accepted: 11/13/2023] [Indexed: 11/20/2023]
Abstract
INTRODUCTION The kinematically alignment (KA) technique for TKA aims to reproduce the pre-arthritic knee anatomy, including both the femoro-tibial and femoro-patellar joints. An in silico study was conducted to compare 3 different femoral component sizing techniques to identify the anatomical landmark which allows closest restoration of the native trochlear anatomy. Our study's question was: what was the best method for sizing the femoral component when performing KA-TKA? It was hypothesized that sizing the femoral component by aiming to restore the groove height would be the best method to restore the native trochlear anatomy. METHODS GMK sphere® (Medacta) femoral component 3D models were virtually kinematically aligned on 30 tri-dimensional (3D) bony osteoarthritis knee models. The femoral component was mediolaterally positioned to match distal native and prosthetic grooves. Three methods were used to size the femoral component: a conventional method with the anterior femoral cut flush to the femoral cortex (C-KATKA) and two alternative personalized methods aiming to recreate either the medial facet's height (ATM-KATKA) or the groove's height (ATG-KATKA). In-house analysis software was used to compare native and prosthetic trochlear articular surfaces and mediolateral implant overhangs. RESULTS Compared with the C-KATKA, ATG-KATKA and ATM-KATKA techniques increased the component size by a mean of 0.90 (SD 0.31, min 0.5 to max 1.5) (p<0.001) and 1.02 (SD 0.31, min 0.5 to max 1.5) (p<0.001), respectively. C-KATKA technique substantially proximally understuffed the trochleae with maximum values of 7.11mm (SD 1.39, min 3.93mm to max 10.57mm) in the medial facet, 4.72mm (SD 1.27, min 1.46mm to max 6.86mm) in the lateral facet and 4.51mm (SD 1.40, min 1.92mm to max 7.30mm) in the groove, respectively. Alternative techniques understuffed medial facet with maximum values of 5.07mm (SD 1.29, min 2.83mm to max 8.34mm) and 4.70mm (SD 1.52, min 0.83mm to max 8.04mm) for ATG-KATKA and ATM-KATKA techniques, respectively. There was no significant understuffing of the groove or lateral facet for alternative techniques (ATM and ATG). The ATM-KATKA and ATG-KATKA techniques generated mediolateral implant overhang, mainly postero-lateral, with a rate of 90.0% and 86.7%, respectively. In this study, no mediolateral implant overhang was found for C-KATKA. DISCUSSION/CONCLUSION The C-KATKA technique substantially understuffs the native trochlear articular surfaces in medial, lateral and groove parts. Alternative techniques (ATM-KATKA and ATG-KATKA) for sizing the femoral component better restore the native trochlear anatomy but also generate a high rate of postero-lateral implant overhangs. Would this postero-lateral implant overhang be clinically deleterious remains unknown? The aspect ratio of contemporary femoral TKA implants can probably be optimized to allow a better anatomical restoration of the anterior femoral compartment. LEVEL OF EVIDENCE II, in silico study.
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Affiliation(s)
- Fasen Huang
- MSK laboratory, Department of Surgery and Cancer, Imperial College London, London W12 0BZ, United Kingdom; Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China
| | - Simon Harris
- MSK laboratory, Department of Surgery and Cancer, Imperial College London, London W12 0BZ, United Kingdom
| | - Tianyu Zhou
- MSK laboratory, Department of Surgery and Cancer, Imperial College London, London W12 0BZ, United Kingdom
| | - Gabriel B Roby
- Bordeaux Arthroplasty Research Institute, 6, rue Georges-Negrevergne, 33700 Mérignac, France
| | - Benjamin Preston
- Imperial College London School of Medicine, South Kensington Campus, London SW7 2DD, United Kingdom
| | - Charles Rivière
- MSK laboratory, Department of Surgery and Cancer, Imperial College London, London W12 0BZ, United Kingdom; Bordeaux Arthroplasty Research Institute, 6, rue Georges-Negrevergne, 33700 Mérignac, France; Clinique du Sport Bordeaux-Mérignac, 4, rue Georges-Negrevergne, 33700 Mérignac, France.
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Molyneux P, Bowen C, Ellis R, Rome K, Fitzgerald K, Clark P, Carroll M. Reliability of an ultrasound imaging acquisition procedure for examining osteoarthritis in the first metatarsophalangeal joint. J Foot Ankle Res 2024; 17:e12002. [PMID: 38551304 PMCID: PMC11296711 DOI: 10.1002/jfa2.12002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 03/01/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE Given the ability of ultrasound imaging (USI) to depict tissue-specific morphological changes before the onset of pain and before the point of irreversible structural damage, USI could play a fundamental role in earlier detection and assessment of foot osteoarthritis (OA). The current guidelines require further refinement of anatomical landmarks to establish a standardized imaging procedure to improve the interpretability and reproducibility between studies evaluating the first metatarsophalangeal joint (MTPJ). The aims were to develop an USI acquisition procedure and grading system to examine OA features in the first MTPJ and to determine intra-examiner and inter-examiner reliability of a newly developed USI acquisition procedure. DESIGN Thirty participants with first MTPJ OA confirmed radiographically with the use of the La Trobe Foot Atlas were included. An experienced sonographer applied a newly developed USI procedure to examine the following features: joint effusion, synovial hypertrophy, synovitis, joint space narrowing, osteophytes, and cartilage thickness. A semiquantitative grading system was applied to all features. A continuous measure was also examined for osteophyte size, joint space narrowing, and cartilage thickness. To determine the intra-examiner and inter-examiner reliability, an experienced radiologist and sonographer applied the developed grading system to the images acquired from two imaging sessions. Intra-examiner and inter-examiner reliability were calculated using intraclass correlation coefficients (ICCs). RESULTS ICCs for intra-examiner between session reliability ranged from 0.58 to 0.92 for semiquantitative grading and 0.39 to 0.94 for continuous measures. Joint effusion and osteophytes achieved the highest intra-examiner reliability (ICC = 0.78-0.94). ICCs for session one inter-examiner reliability ranged from 0.61 to 1.0 for semiquantitative grading; all continuous measures had an ICC of 1. ICCs for session two inter-examiner reliability ranged from 0.55 to 1.0 for semiquantitative grading and 0.9 to 0.97 for continuous measures. Inter-examiner reliability was good for grading joint effusion (ICC = 0.55-0.62) and was excellent for all other USI features (ICC = 0.77-1.0). CONCLUSION The USI acquisition procedure and grading system are reliable in evaluating first MTPJ OA features in participants with radiologically confirmed OA. The study will inform the methodological development of an ultrasound atlas for grading the degree of osteoarthritic change in the first MTPJ.
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Affiliation(s)
- Prue Molyneux
- School of Clinical SciencesAuckland University of TechnologyAucklandNew Zealand
- Active Living and Rehabilitation: Aotearoa New ZealandHealth and Rehabilitation Research InstituteSchool of Clinical SciencesAuckland University of TechnologyAucklandNew Zealand
| | - Catherine Bowen
- School of Health SciencesFaculty of Environmental and Life SciencesUniversity of SouthamptonSouthamptonUK
- Centre for Sport, Exercise and Osteoarthritis Versus ArthritisUniversity of SouthamptonSouthamptonUK
| | - Richard Ellis
- School of Clinical SciencesAuckland University of TechnologyAucklandNew Zealand
- Active Living and Rehabilitation: Aotearoa New ZealandHealth and Rehabilitation Research InstituteSchool of Clinical SciencesAuckland University of TechnologyAucklandNew Zealand
| | - Keith Rome
- School of Clinical SciencesAuckland University of TechnologyAucklandNew Zealand
| | | | | | - Matthew Carroll
- School of Clinical SciencesAuckland University of TechnologyAucklandNew Zealand
- Active Living and Rehabilitation: Aotearoa New ZealandHealth and Rehabilitation Research InstituteSchool of Clinical SciencesAuckland University of TechnologyAucklandNew Zealand
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Veličković1† Z, Pavlov Dolijanović S, Stojanović N, Janjić S, Kovačević L, Soldatović I, Radunović G. The short-term effect of glucosamine-sulfate, nonanimal chondroitin-sulfate, and S-adenosylmethionine combination on ultrasonography findings, inflammation, pain, and functionality in patients with knee osteoarthritis: A pilot, double-blind, randomized, placebo-controlled clinical trial. Arch Rheumatol 2023; 38:521-541. [PMID: 38125054 PMCID: PMC10728741 DOI: 10.46497/archrheumatol.2023.9994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/14/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives This study aimed to investigate the efficacy of glucosamine-sulfate (GS), nonanimal chondroitin-sulfate (naCS), and S-adenosylmethionine (SAMe) combination on ultrasound findings, inflammation, pain, and functionality in knee osteoarthritis. Patients and methods In the prospective, randomized, double-blind, placebo-controlled pilot study conducted between August 2019 and November 2019, 120 participants (28 males, 92 females; mean age: 66.4±7.9 years; range, 42.4 to 74.5 years) were randomized at a 1:1:1 ratio to the placebo group, the first experimental group (a combination of GS, naCS, and SAMe was administered to the experimental groups. The first experimental group received 375 mg of GS, 300 mg of naCS, and 100 mg of SAMe, whereas the second experimental group received 750 mg of GS, 600 mg of naCS, and 200 mg of SAMe). Laboratory (erythrocyte sedimentation rate, C-reactive protein, tumor necrosis factor alpha, interleukin [IL]-1β, IL-6, IL-17), clinical (Visual Analog Scale [VAS], short form health survey [SF-36], the Western Ontario and McMaster Universities Arthritis Index [WOMAC], and the Tegner Lysholm Knee Scoring Scale [TLKS]), and musculoskeletal ultrasound (MSUS) assessments were performed at baseline and after three and six months. Results A minor increase was observed in the second experimental group after six months using ultrasonography to evaluate articular cartilage thickness (p<0.05). The investigational product's superiority in reducing osteoarthritis ultrasonographic findings was not proven. A moderately negative association was found between cartilage thickness and VAS scores at baseline (ρ=-0.36, p<0.01), while the presence of massive osteophytes on MSUS showed a low to moderate association with all clinical outcomes. There was no difference in the delta changes between groups for the VAS, TLKS, WOMAC, and SF-36. The only serum inflammatory marker outside the reference range was IL-1β, but no significant changes were observed after six months. Conclusion According to the results of our investigation, treatment for knee osteoarthritis should be evaluated using more objective outcomes. The most important conclusion of our study is that IP may result in a slight increase in articular cartilage thickness, which was associated with a decrease in pain intensity at baseline. Clarification of the potential influence of this combination on radiographic progression and laboratory markers of inflammation requires further exploration.
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Affiliation(s)
| | | | | | | | | | - Ivan Soldatović
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Medical Statistics and Informatics, Belgrade, Serbia
| | - Goran Radunović
- Institute of Rheumatology, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
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Taş S, Aktaş A, Dikici TF, Çekok FK. Achilles Tendon, Patellar Tendon, and Femoral Cartilage Thickness in Control vs Asymptomatic Flatfoot Young Adults. Foot Ankle Int 2023; 44:81-88. [PMID: 36412188 DOI: 10.1177/10711007221136137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Changes in lower extremity alignment in individuals with flatfoot may be associated with differences in morphology of the tendons or cartilage in lower extremities. The purpose of the present study was to investigate the potential association of flatfoot with the morphology of the Achilles tendon, patellar tendon, and femoral cartilage. METHODS This study was conducted with 40 participants with flatfoot (28 females, 12 males) and 40 participants with a normal foot posture (28 females, 12 males). The thickness of the Achilles tendon (at points 2 and 3 cm proximal to the superior aspect of the calcaneus), patellar tendon (at the inferior pole of the patella and 1 cm proximal of the inferior pole of the patella), and femoral cartilage (at the intercondylar area, medial condyle, and lateral condyle) was measured by an ultrasonography device. RESULTS The Achilles tendon thickness at 2 cm (P = .009) and 3 cm (P = .010) proximal of the superior aspect of the calcaneus was on average 4% to 6% lower in individuals with flatfoot compared with controls. The cartilage thickness at the intercondylar area (P = .005) and medial condyle (P = .018) was on average 8% to 12% greater in individuals with flatfoot; however, the cartilage thickness at the lateral condyle and patellar tendon thickness was similar in both groups. CONCLUSION The results obtained suggest that foot posture is associated with the morphology of the Achilles tendon and femoral cartilage. LEVEL OF EVIDENCE Level III, diagnostic comparative study.
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Affiliation(s)
- Serkan Taş
- Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Toros University, Mersin, Turkey
| | - Arda Aktaş
- Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Toros University, Mersin, Turkey
| | - Tahir Fatih Dikici
- Vocational School of Health Services, Department of Physiotherapy, Alanya Keykubat University, Antalya, Turkey
| | - Fatma Kübra Çekok
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilition, Tarsus University, Mersin, Turkey
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Schlüter IM, Prill R, Królikowska A, Cruysen C, Becker R. A Pilot Study on the Reliability of Ultrasound-Based Assessment of Patella Diameter and Sulcus Angle. Diagnostics (Basel) 2022; 12:3164. [PMID: 36553171 PMCID: PMC9777322 DOI: 10.3390/diagnostics12123164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
This pilot study aimed to determine the reliability of a newly developed ultrasound-based protocol for the assessment of patella diameter and sulcus angle. The diameter of the patella expressed in mm and the sulcus angle, expressed in degrees were measured in the right knee in 12 healthy participants (eight women and four men) in two separate sessions by two examiners (experienced rater and inexperienced rater) using ultrasonography according to a developed standardized protocol. The reliability was determined on the calculated intraclass correlation coefficient, ICC, expressed as a 95% confidence interval (lower bound, upper bound). For the patella diameter measurement, intra-rater and inter-rater reliability were good to excellent, with the ICC exceeding 0.836-0.998 and 0.859-0.997, respectively. The intra-rater and inter-rater reliability of the sulcus measurement was moderate to excellent, as the ICC amounted to 0.559-0.993 and 0.559-0.990, respectively. The reliability of both measures increased with the experience of the examiner. Therefore, it was determined that the newly developed protocol for an ultrasound-based assessment of patella diameter and sulcus angle is reliable. Further studies validating their clinical use should be carried out.
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Affiliation(s)
- Isa-Maria Schlüter
- Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Caren Cruysen
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
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Harkey MS, Michel N, Kuenze C, Fajardo R, Salzler M, Driban JB, Hacihaliloglu I. Validating a Semi-Automated Technique for Segmenting Femoral Articular Cartilage on Ultrasound Images. Cartilage 2022; 13:19476035221093069. [PMID: 35438030 PMCID: PMC9251823 DOI: 10.1177/19476035221093069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To validate a semi-automated technique to segment ultrasound-assessed femoral cartilage without compromising segmentation accuracy to a traditional manual segmentation technique in participants with an anterior cruciate ligament injury (ACL). DESIGN We recruited 27 participants with a primary unilateral ACL injury at a pre-operative clinic visit. One investigator performed a transverse suprapatellar ultrasound scan with the participant's ACL injured knee in maximum flexion. Three femoral cartilage ultrasound images were recorded. A single expert reader manually segmented the femoral cartilage cross-sectional area in each image. In addition, we created a semi-automatic program to segment the cartilage using a random walker-based method. We quantified the average cartilage thickness and echo-intensity for the manual and semi-automated segmentations. Intraclass correlation coefficients (ICC2,k) and Bland-Altman plots were used to validate the semi-automated technique to the manual segmentation for assessing average cartilage thickness and echo-intensity. A dice correlation coefficient was used to quantify the overlap between the segmentations created with the semi-automated and manual techniques. RESULTS For average cartilage thickness, there was excellent reliability (ICC2,k = 0.99) and a small mean difference (+0.8%) between the manual and semi-automated segmentations. For average echo-intensity, there was excellent reliability (ICC2,k = 0.97) and a small mean difference (-2.5%) between the manual and semi-automated segmentations. The average dice correlation coefficient between the manual segmentation and semi-automated segmentation was 0.90, indicating high overlap between techniques. CONCLUSIONS Our novel semi-automated segmentation technique is a valid method that requires less technical expertise and time than manual segmentation in patients after ACL injury.
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Affiliation(s)
- Matthew S. Harkey
- Department of Kinesiology, Michigan
State University, East Lansing, MI, USA,Matthew S. Harkey, Department of
Kinesiology, Michigan State University, 308 W. Circle Drive #112, East Lansing,
MI 48824, USA.
| | - Nicholas Michel
- College of Osteopathic Medicine,
Michigan State University, East Lansing, MI, USA
| | - Christopher Kuenze
- Department of Kinesiology, Michigan
State University, East Lansing, MI, USA
| | - Ryan Fajardo
- Department of Radiology, Michigan State
University, East Lansing, MI, USA
| | - Matt Salzler
- Department of Orthopaedics, Tufts
Medical Center, Boston, MA, USA
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and
Immunology, Tufts Medical Center, Boston, MA, USA
| | - Ilker Hacihaliloglu
- Department of Radiology, Department of
Medicine, The University of British Columbia, Vancouver, BC, Canada
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Roberts HM, Griffith-McGeever CL, Owen JA, Angell L, Moore JP, Thom JM. An exploratory study to investigate the association between age, physical activity, femoral trochlear cartilage thickness and biomarkers of tissue metabolism in adult males. Eur J Appl Physiol 2021; 121:1871-1880. [PMID: 33713200 PMCID: PMC8192398 DOI: 10.1007/s00421-021-04655-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 02/25/2021] [Indexed: 11/27/2022]
Abstract
Purpose To investigate the association between age, physical activity, femoral trochlear cartilage thickness and biomarkers of tissue metabolism in a cross-sectional sample of adult males. This study utilizes several emerging biomarkers that have been associated with early joint degenerative changes; serum COMP (cartilage oligomeric matrix protein), HA (hyaluronan) and lubricin. Methods Eighty-one males (age: mean (range): 43(18–70) years; body mass index: 25.2 (21.0–30.6) kg/m2) volunteered. Resting serum COMP, HA and lubricin concentrations were determined via commercially available enzyme-linked immunosorbent assay (ELISA) and femoral trochlear cartilage thickness via supra-patellar ultrasound imaging. Physical activity levels were assessed using questionnaires. Statistical analyses were performed using correlation and regression analyses. Results Age was correlated with lateral trochlear cartilage thickness (r = − 0.372; p < 0.01) and serum COMP (r = 0.342; p < 0.01). 7-day physical activity was correlated with serum COMP (r = 0.357, p < 0.01), and 12-month physical activity with both lateral trochlear cartilage thickness (r = 0.340, p = 0.01) and serum HA (r = 0.296, p < 0.05). Regression analyses revealed that age significantly accounted for the variability in lateral cartilage thickness and serum COMP, following the adjustment for potential cofounders. However, the association between age and lateral trochlear cartilage thickness was not moderated by physical activity levels (all p > 0.05). Conclusion This study indicates that older age may be associated with thinner lateral trochlear cartilage and higher cartilage turnover. Being physically active may also be positive for lateral trochlear cartilage thickness. However, overall, both age and physical activity level only account for a small amount of the variability in cartilage thickness and serum biomarkers.
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Affiliation(s)
- Harry M Roberts
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK. .,School of Biosciences and Medicine, University of Surrey, The Leggett Building, Daphne Jackson Road, Guildford, GU2 7WG, UK.
| | - Claire L Griffith-McGeever
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Julian A Owen
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Lewis Angell
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Jonathan P Moore
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Jeanette M Thom
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK.,School of Medical Sciences, University of New South Wales, Sydney, Australia
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Harkey MS, Little E, Thompson M, Zhang M, Driban JB, Salzler MJ. Femoral Cartilage Ultrasound Echo Intensity Associates with Arthroscopic Cartilage Damage. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:43-50. [PMID: 33082054 PMCID: PMC7568485 DOI: 10.1016/j.ultrasmedbio.2020.09.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 05/21/2023]
Abstract
This study compared quantitative cartilage ultrasound metrics between people with (n = 12) and without (n = 12) arthroscopic cartilage damage after anterior cruciate ligament injury (age, 24.9 ± 3.7 y; sex, 33% female, 67% male; days since injury = 50 ± 52). A transverse suprapatellar ultrasound assessment imaged the femoral cartilage in participants' injured knees before a clinical arthroscopy. A custom program automatically separated a manual cartilage segmentation into standardized medial and lateral femoral regions and calculated mean thickness (i.e., cross-sectional area/length of cartilage-bone interface), mean echo intensity and echo-intensity heterogeneity. An orthopedic surgeon assessed arthroscopic cartilage damage in the medial and lateral femoral condyles using the Outerbridge grading system (cartilage damage = Outerbridge ≥ 1). Separate logistic regressions for medial and lateral femoral cartilage were used to determine the association between each ultrasound metric and arthroscopic cartilage damage. In medial femoral cartilage, for every 1 standard deviation decrease in echo-intensity mean and heterogeneity, there is, respectively, a 91% (adjusted odds ratio, 0.09; 95% confidence interval, 0.01-0.69) and 97% (adjusted odds ratio, 0.03; 95% confidence interval, 0.002-0.50) increase in the odds of having arthroscopic cartilage damage. Lateral cartilage ultrasound metrics are not associated with lateral arthroscopic cartilage damage. This study provides preliminary evidence that femoral cartilage ultrasound echo intensity is a non-invasive measure associated with medial femoral cartilage health after anterior cruciate ligament injury.
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Affiliation(s)
- Matthew S Harkey
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA; Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, Massachusetts, USA; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
| | - Erin Little
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Mikaela Thompson
- Department of Orthopaedics, Tufts Medical Center, Boston, Massachusetts, USA
| | - Ming Zhang
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, Massachusetts, USA; Department of Computer Science & Networking, Wentworth Institute of Technology, Boston, Massachusetts, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Matthew J Salzler
- Department of Orthopaedics, Tufts Medical Center, Boston, Massachusetts, USA
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Reliability of a Novel Semiautomated Ultrasound Segmentation Technique for Assessing Average Regional Femoral Articular Cartilage Thickness. J Sport Rehabil 2020; 29:1042-1046. [DOI: 10.1123/jsr.2019-0476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/13/2020] [Accepted: 03/01/2020] [Indexed: 11/18/2022]
Abstract
Context: Ultrasound imaging is a clinically feasible tool to assess femoral articular cartilage and may have utility in tracking early knee osteoarthritis development. Traditional assessment techniques focus on measurements at a single location, which can be challenging to adopt for novice raters. Objective: To introduce a novel semiautomated ultrasound segmentation technique and determine the intrarater and interrater reliability of average regional femoral articular cartilage thickness and echo intensity of a novice and expert rater. Design: Descriptive observational study. Setting: Orthopedic clinic. Patients or Other Participants: Fifteen participants (mean [SD]; age 23.5 [4.6] y, height = 172.6 [9.3] cm, mass = 79.8 [15.7] kg) with a unilateral history of anterior cruciate ligament reconstruction participated. Intervention: None. Main Outcome Measures: One rater captured anterior femoral cartilage images of the participants’ contralateral knees using a transverse suprapatellar ultrasound assessment. The total femoral cartilage cross-sectional area of each image was segmented by a novice and expert rater. A novel custom program automatically separated the cartilage segmentations into medial, lateral, and intercondylar regions to determine the cross-sectional area and cartilage length. The average cartilage thickness in each region was calculated by dividing the cross-sectional area by the cartilage length. Echo intensity was calculated as the average gray-scale pixel value of each region. Two-way random effect intraclass correlations coefficient (ICC) for absolute agreement were used to determine the interrater reliability between a novice and expert rater, as well as the intrarater reliability of the novice rater. Results: The novice rater demonstrated excellent intrarater (ICC [2,k] range = .993–.997) and interrater (ICC [2,k] range = .944–.991) reliability with the expert rater of all femoral articular cartilage average thickness and echo intensity regions. Conclusions: The novel semiautomated average cartilage thickness and echo-intensity assessment is efficient, systematic, and reliable between an expert and novice rater with minimal training.
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Bedewi MA, Elsifey AA, Naguib MF, Saleh AK, Nwihadh NB, Abd-Elghany AA, Swify SM. Sonographic assessment of femoral cartilage thickness in healthy adults. J Int Med Res 2020; 48:300060520948754. [PMID: 32811271 PMCID: PMC7441287 DOI: 10.1177/0300060520948754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study was performed to obtain normative data of the distal femoral cartilage thickness in healthy adults by ultrasound. METHODS This cross-sectional study included 72 healthy adults. The demographic characteristics of the participants were recorded, and the thickness of the femoral articular cartilage was measured using a 5- to 18-MHz linear probe. RESULTS Significant statistical difference towards the male side at left medial condyle (P = 0.001) and left lateral condyle (P = 0.009). Weakly positive statistical difference was noted towards the male side at right medial condyle (P = 0.06) and right lateral condyle (P = 0.07). The femoral cartilage thickness in the study participants did not correlate with weight, body mass index, and age (P >0.05). Positive statistical correlation with height noted in right medial condyle, right lateral condyle, right intercondylar area, and left medial condyle. CONCLUSION This study increases the pool of normative data of femoral cartilage thickness measurements. Additionally, the findings of this study emphasize the fact that women have thinner cartilage than men in four of the studied parameters.
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Affiliation(s)
- Mohamed A Bedewi
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz University, College of Medicine, Al-Kharj, Kingdom of Saudi Arabia
| | - Ayman A Elsifey
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz University, College of Medicine, Al-Kharj, Kingdom of Saudi Arabia
| | - Moheyeldeen F Naguib
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz University, College of Medicine, Al-Kharj, Kingdom of Saudi Arabia
| | - Ayman K Saleh
- Department of Surgery, Prince Sattam Bin Abdulaziz University, College of Medicine, Al-Kharj, Kingdom of Saudi Arabia.,Orthopedic Department, Faculty of Medicine for Girls, Alazhar University, Cairo, Egypt
| | - Naif Bin Nwihadh
- Department of Surgery, Prince Sattam Bin Abdulaziz University, College of Medicine, Al-Kharj, Kingdom of Saudi Arabia
| | - Amr A Abd-Elghany
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdul-Aziz University, Al-Kharj, Kingdom of Saudi Arabia.,Biophysics Department, Faculty of Science, Cairo University, Cairo University St., Giza, Egypt
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Bedewi MA, Elsifey AA, Naguib MF, Saleh AK, Al-Ghamdi S, Alhariqi BA, Aldossary NM, Gould ES. Ultrasonographic measurement of femoral cartilage thickness in type II diabetic patients. Medicine (Baltimore) 2020; 99:e19455. [PMID: 32243364 PMCID: PMC7220742 DOI: 10.1097/md.0000000000019455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study is to compare the distal femoral cartilage thickness of patients with type II diabetes mellitus with those of healthy subjects using ultrasonography. The study comprised 34 patients and 36 healthy subjects. Demographic characteristics of all the participants were recorded. The thickness of the femoral articular cartilage was measured using a 5-18MHzlinearprobe.Measurements were performed bilaterally from three points (intercondylar area, medial condyle, and lateral condyle). No significant difference could be found between patients and healthy subjects. Two demographic characteristics correlated positively with diabetic patients.
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Affiliation(s)
- Mohamed A. Bedewi
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine
| | - Ayman A. Elsifey
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine
| | - Moheyeldeen F. Naguib
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine
| | - Ayman K. Saleh
- Department of Surgery, Prince Sattam Bin Abdulaziz university, College of Medicine, Kingdom of Saudi Arabia
- Orthopedic Department, Faculty of Medicine for Girls, Alazhar University, Cairo, Egypt
| | - Sameer Al-Ghamdi
- Department of Family Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine, Kingdom of Saudi Arabia
| | - Bader A. Alhariqi
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine
| | - Nasser M. Aldossary
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine
| | - Elaine S. Gould
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
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Lee SW, Patel J, Van Dien C, Ayutyanont N, Naguib A, Emam M, Kim S. The Transverse Infrapatellar View: A New Ultrasound Technique to Measure Distal Femoral Cartilage Thickness. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:463-470. [PMID: 31452247 DOI: 10.1002/jum.15122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To examine the reliability and face validity of ultrasound (US) measurements of distal femoral cartilage thickness (CT) using the infrapatellar view (IPV) with knee extension compared to the traditional suprapatellar view (SPV) with knee hyperflexion in young asymptomatic participants and patients with painful knee osteoarthritis (KOA). METHODS The IPV was obtained in an extended knee position by placing the US transducer on the patellar tendon at a 60° angle tilted toward the distal femoral condyle in 19 young adults (control group) and 70 patients with KOA. The CT was measured at the medial femoral condyle, the intercondylar notch, and the lateral femoral condyle. RESULTS The inter-rater intraclass correlation coefficient was higher for IPV-based CT measurement (range, 0.856-0.858) compared to SPV-based CT measurement (range, 0.315-0.523) among the patients with symptomatic KOA. The IPV-based CT differed significantly between the control group and the KOA group at the intercondylar notch (P < .001) and lateral femoral condyle (P = .006). The SPV-based CT differed significantly between the control group and the KOA group only at the lateral femoral condyle region (P = .014). CONCLUSIONS An infrapatellar US evaluation of the distal femoral CT can be a reliable alternative method to a suprapatellar US evaluation for patients with KOA.
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Affiliation(s)
- Se Won Lee
- Department of Physical Medicine and Rehabilitation, Sunrise Health GME Consortium, Las Vegas, Nevada, USA
| | - Jasal Patel
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Craig Van Dien
- Department of Physical Medicine and Rehabilitation, JFK Johnson Rehabilitation Institute, Edison, New Jersey, USA
| | - Napatkamon Ayutyanont
- Department of Physical Medicine and Rehabilitation, Sunrise Health GME Consortium, Las Vegas, Nevada, USA
| | - Abir Naguib
- Department of Physical Medicine and Rehabilitation, Creighton University, Omaha, Nebraska, USA
| | - Mohammed Emam
- Department of Orthopedics and Rehabilitation Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Sooyeon Kim
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
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