Murat UÇAR, Mehmet KURT, Seda ALADAĞ KURT, Ali Yusuf ÖNER

The relationship between patellofemoral arthritis and fat tissue volume, body mass index and popliteal artery intima-media thickness through 3T knee MRI

Background/aim: Evaluating the relationship of patellar chondromalacia with obesity, infrapatellar fat pad (IFP) volume and poplitealartery intima-media thickness (IMT).Materials and methods: A total of 203 patients with different degree of patellar chondromalacia (103 male, 100 female) and 52 controlsubjects (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). Articularcartilage 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.Results: Popliteal 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 anddifferent chondromalacia groups. When IFP measurements were corrected using individual BMI and BSA values, a positive correlationwas found between control and advanced chondromalacia groups (P ˂ 0.001).Conclusion: This study demonstrates the relationship among obesity, IMT and chondromalacia and highlights this potential circle todevelop effective treatments and inhibit the progression of chondromalacia.

PDF

___

1. Eymard F, Pigenet, A, Citadelle D, Flouzat-Lachaniette CH, Poignard A, Benelli C, Berenbaum F, Chevalier X, Houard X. Induction of an inflammatory and prodegradative phenotype in autologous fibroblast-like synoviocytes by the infrapatellar fat pad from patients with knee osteoarthritis. Arthritis Rheumatology 2014; 66 (8): 2165-2174.
2. Masaki T, Takahashi K, Hashimoto S, Ikuta F, Watanabe A, Kiuchi S, Okuaki T, Mochizuki Y, Takai S. Volume change in infrapatellar fat pad is associated not with obesity but with cartilage degeneration. Journal of Orthopaedic Research 2019; 37 (3): 593-600.
3. Clockaerts S, Bastiaansen-Jenniskens YM, Runhaar J, Van Osch GJ, Van Offel JF, Verhaar JA, De Clerk LS, Somville J. The infrapatellar fat pad should be considered as an active osteoarthritic joint issue: a narrative review. Osteoarthritis and Cartilage 2010; 18 (7): 876-882.
4. Kornaat PR, Sharma R, van der Geest RJ, Lamb HJ, Kloppenburg M, Heillo le Graverand MP, Bloem JL, Watt I. Positive association between increased popliteal artery vessel wall thickness and generalized osteoarthritis: is OA also part of the metabolic syndrome? Skeletal Radiology 2009; 38 (12): 1147-1151.
5. Nakamura T. Visceral fat and risk factors for atherosclerosis. Internal Medicine 2004; 43 (12): 1095-1096.
6. Ohman MK, Wright AP, Wickenheiser KJ, Luo W, Eitzman DT. Visceral adipose tissue and atherosclerosis. Current Vascular Pharmacology 2009; 7 (2): 169-179.
7. Chuckpaiwong B, Charles HC, Kraus VB, Guilak F, Nunley JA. Age-associated increases in the size of the infrapatellar fat pad in knee osteoarthritis as measured by 3T MRI. Journal of Orthopaedic Research 2010; 28 (9): 1149-1154.
8. Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy 1997; 13 (4): 456-460.
9. Jungius KP, Schmid MR, Zanetti M, Hodler J, Koch P, Pfirrmann CW. Cartilaginous defects of the femorotibial joint: accuracy of coronal short inversion time inversion-recovery MR sequence. Radiology 2006; 240 (2): 482-488.
10. Baysal O, Baysal T, Alkan A, Altay Z, Yologlu S. Comparison of MRI graded cartilage and MRI based volume measurement in knee osteoarthritis. Swiss Medical Weekly 2004; 134 (19-20): 283-288.
11. Pruessmann KP, Weiger M, Scheidegger MB, Boesiger P. SENSE: Sensitivity encoding for fast MRI. Magnetic Resonance in Medicine. 1999; 42 (5): 952-962.
12. Ma J, Singh SK, Kumar AJ, Leeds NE, Broemeling LD. Method for efficient fast spin echo Dixon imaging. Magnetic Resonance in Medicine 2002; 48 (6): 1021-1027.
13. Reeder SB, Wen Z, Yu H, Pineda AR, Gold GE, Markl M, Pelc NJ. Multicoil Dixon chemical species separation with an iterative least-squares estimation method. Magnetic Resonance in Medicine 2004; 51 (1): 35-45.
14. Yu H, Reeder SB, Shimakawa A, Gold GE, Pelc NJ, Brittain JH. Implementation and noise analysis of chemical shift correction for fast spin echo Dixon imaging. In: Proceedings of the 12th Annual Meeting of ISMRM, Kyoto, JAPAN. pp. 2686.
15. Bley TA, Wieben O, François CJ, Brittain JH, Reeder SB. Fat and water magnetic resonance imaging. Journal of Magnetic Resonance Imaging 2010; 31 (1): 4-18.
16. Davies AP, Vince AS, Shepstone L, Donell ST, Glasgow MM. The radiologic prevalence of patellofemoral osteoarthritis. Clinical Orthopaedics and Related Research 2002; 402: 206- 212.
17. Fujisawa T, Hattori T, Takahashi K, Kuboki T, Yamashita A, Takigawa M. Cyclic mechanical stress induces extracellular matrix degradation in cultured chondrocytes via gene expression of matrix metalloproteinases and interleukin-1. Journal of Biochemistry 1999; 125 (5): 966-975.
18. Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman B, Aliabadi P, Levy D. Risk factors for incident radiographic knee osteoarthritis in the elderly: The Framingham Study. Arthritis & Rheumatology 1997; 40 (4): 728-733.
19. Lementowski PW, Zelicof SB. Obesity and osteoarthritis. American Journal of Orthopedics (Belle Mead NJ) 2008; 37 (3): 148-151.
20. Coggon D, Reading I, Croft P, McLaren M, Barrett D, Cooper C. Knee osteoarthritis and obesity. International Journal of Obesity 2001; 25: 622-627.
21. Kok HK, Donnellan J, Ryan D, Torreggiani WC. Correlation between subcutaneous knee fat thickness and chondromalacia patellae on magnetic resonance imaging of the knee. Canadian Association of Radiologists Journal 2013; 64 (3): 182-186.
22. Han W, Cai S, Liu Z, Jin X, Wang X, Antony B, Cao Y, Aitken D, Cicuttini F, Jones G, et al. Infrapatellar fat pad in the knee: is local fat good or bad for knee osteoarthritis? Arthritis Research & Therapy 2014; 16: R145.
23. Cai J, Xu J, Wang K, Zheng S, He F, Huan S, Xu S, Zhang H, Laslett L, Ding C. Association between infrapatellar fat pad volume and knee structural changes in patients with knee osteoarthritis. The Journal of Rheumatology 2015; 42 (10): 1878-1884.
24. Fontanella CG, Belluzzi E, Rossato M, Olivotto E, Trisolino G, Ruggieri P, Rubini A, Porzionato A, Natali A, De Caro R, et al. Quantitative MRI analysis of infrapatellar and suprapatellar fat pads in normal controls, moderate and end-stage osteoarthritis. Annals of Anatomy-Anatomischer Anzeiger 2019; 221: 108- 114.
25. Teichtahl AJ, Wluka AE, Wang Y, Hanna F, English DR, Giles GG, Cicuttini FM. Obesity and adiposity are associated with the rate of patellar cartilage volume loss over 2 years in adults without knee osteoarthritis. Annals of the Rheumatic Diseases. 2009; 68 (6): 909-913.
26. Teichtahl AJ, Wang Y, Wluka AE, Szramka M, English DR, Giles GG, O’Sullivan R, Cicuttini FM. The longitudinal relationship between body composition and patella cartilage in healthy adults. Obesity 2008; 16 (2): 421-427.
27. Safar ME, Czernichow S, Blacher J. Obesity, arterial stiffness, and cardiovascular risk. Journal of the American Society of Nephrology 2006; 17: 109-111.
28. Jonsson H, Helgadottir GP, Aspelund T, Eiriksdottir G, Sigurdsson S, Ingvarsson T, Harris TB, Launer L, Gudnason V. Hand osteoarthritis in older women is associated with carotid and coronary atherosclerosis: the AGES Reykjavik study. Annals of the Rheumatic Diseases. 2009; 68 (11): 1696-1700.
29. Hoeven TA, Kavousi M, Clockaerts S, Kerkhof HJ, van Meurs JB, Franco O, Hofman A, Bindels P, Witteman J, BiermaZeinstra S. Association of atherosclerosis with presence and progression of osteoarthritis: the Rotterdam Study. Annals of the Rheumatic Diseases. 2013; 72 (5): 646-651.