Quantitative relationships of normal cartilage volumes of the human knee joint - assessment by magnetic resonance imaging

Abstract

The objective of this study was to assess the normal range of cartilage volumes in the knee joints of healthy adults, the ratio between the patellar, femoral, and tibial cartilages, and the correlation of the volumes with age, body weight, height, body mass index (obesity), patellar bone size, and the diameter of the tibial head. We examined the knee joints of nine healthy volunteers and eleven normal post-mortem specimens with an age range of 24 to 82 years. The cartilage volumes of the patella, femur, medial tibia and the lateral tibia were quantified, using a fat-suppressed FLASH-3D sequence (resolution 2x0.31x0.31 mm3) and digital postprocessing, involving three-dimensional reconstruction. The mean total volume of the knee joint cartilage was 23,245 mm3, the relative standard deviation (CV%) 19%, and the range 16,341 to 33,988 mm3. In the patella, femur and tibia, the CV% amounted to between 22 and 25%. These joint surfaces occupied a relatively variable proportion of the total knee joint volume, the percentage of the patella being 11 to 22%, that of the femur 54 to 69%, that of the medial tibia 7 to 12%, and that of lateral tibia 11 to 16%. The volumes of the lateral tibia were systematically higher than those of the medial tibia (P<0.001). There was no significant correlation of the knee joint cartilage volume with age (r=+0.05), body weight (r=+0.38), height (r=+0.39) or body mass index (r=+0.29), but a relatively high correlation with the diameter of the tibial head (r=+0.78, P<0.001). After normalising the volumes to this diameter, the CV% of the total knee joint cartilage volume was reduced to 13%, its variation being 12 to 21% in the patella, femur and tibia. MRI is available for measuring cartilage volume during growth, functional adaptation, and tissue loss in degenerative joint disease. The study shows that a wide variation of cartilage volumes exists in the knee joints of normal adults. To reduce the variability between individuals, the cartilage volumes may be normalised to the head of the tibial diameter.

Correlation of knee‐joint cartilage morphology with muscle cross‐sectional areas vs. anthropometric variables

“…Previous studies found a relatively weak association of cartilage morphology with body weight and height (Karvonen et al, 1994;Dalla Palma et al, 1997;Eckstein et al, 1998aEckstein et al, , 2001aCicuttini et al, 1999;Jones et al, 2000). Jones et al (2000) found a significant (albeit weak) correlation between muscle force and cartilage volume of the patella and the lateral tibia in children (9 -18 years old), but no significant association in the medial tibia.…”

“…In conjunction with state-of-the-art three-dimensional (3D) postprocessing tools (qMRI) the technique has been shown to produce accurate and precise data on the cartilage morphology (volume, thickness, and surface area) of the knee in healthy individuals (Stammberger et al, 1999a;Hohe et al, 2002), and in patients with femorotibial osteoarthritis (OA) (Burgkart et al, 2001). Various studies have revealed that the knee-joint cartilage volume displays a high intersubject variability (Eckstein et al, 1998a(Eckstein et al, , 2001aCicuttini et al, 1999;Jones et al, 2000), but little is known about the determinants of this variability. Several authors (Karvonen et al, 1994;Cova et al, 1996;Dalla Palma et al, 1997;Eckstein et al, 1998aEckstein et al, , 2001aCicuttini et al, 1999;Jones et al, 2000) have investigated the correlation of knee-joint cartilage morphology with anthropometric variables such as body height, body weight, and age.…”

“…Various studies have revealed that the knee-joint cartilage volume displays a high intersubject variability (Eckstein et al, 1998a(Eckstein et al, , 2001aCicuttini et al, 1999;Jones et al, 2000), but little is known about the determinants of this variability. Several authors (Karvonen et al, 1994;Cova et al, 1996;Dalla Palma et al, 1997;Eckstein et al, 1998aEckstein et al, , 2001aCicuttini et al, 1999;Jones et al, 2000) have investigated the correlation of knee-joint cartilage morphology with anthropometric variables such as body height, body weight, and age. Body height and weight have been shown to be only weakly correlated with cartilage volume (Dalla Palma et al, 1997;Eckstein et al, 1998a;Cicuttini et al, 1999;Jones et al, 2000), and in particular with cartilage thickness (Karvonen et al, 1994;Eckstein et al, 2001a).…”

“…Several authors (Karvonen et al, 1994;Cova et al, 1996;Dalla Palma et al, 1997;Eckstein et al, 1998aEckstein et al, , 2001aCicuttini et al, 1999;Jones et al, 2000) have investigated the correlation of knee-joint cartilage morphology with anthropometric variables such as body height, body weight, and age. Body height and weight have been shown to be only weakly correlated with cartilage volume (Dalla Palma et al, 1997;Eckstein et al, 1998a;Cicuttini et al, 1999;Jones et al, 2000), and in particular with cartilage thickness (Karvonen et al, 1994;Eckstein et al, 2001a). Considering that cartilage thickness may depend on the "loading history" of the joint (Kurrat and Oberlä nder, 1978;Mü ller-Gerbl et al, 1987;Carter et al, 1991;Eckstein et al, 1992;Adam et al, 1998), muscle cross-sectional areas (MCSAs) and muscle forces may provide better estimates of cartilage morphology than body height and weight or other anthropometric variables, because MCSAs have been shown to be strongly associated with muscle strength (Maughan et al, 1983;Brand et al, 1986), whereas joint loads are mainly determined by muscle force .…”

Quantitative magnetic resonance imaging evaluation of knee osteoarthritis progression over two years and correlation with clinical symptoms and radiologic changes

“…Recent advances in MRI technology have led to significant improvements in spatial resolution and contrast, enabling researchers to evaluate anatomic damage of all these joint structures in the axial, coronal, and sagittal planes (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Recently, we and other investigators have developed a system for quantifying cartilage volume using MRI acquisitions combined with sophisticated software (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41); however, to date, few studies have used MRI technology to evaluate cartilage volume changes over time (42)(43)(44)(45)(46). Some clinical parameters, such as age, weight, body mass index (BMI), trauma, and baseline radiologic JSW, have already been identified as predictors of rapid radiologic progression of knee OA (47,48).…”