Shape of the intercondylar notch of the human femur: a comparison of osteoarthritic and non-osteoarthritic bones from a skeletal sample

Abstract

Objectives-To compare objectively the shape of the intercondylar notch in human osteoarthritic and non-osteoarthritic femora. Methods-A sample of 96 human femora from a large skeletal population were selected for study. These femora included subjects with evidence of late stage osteoarthritis (that is, with eburnation present) and subjects with no such evidence. The distal end of the femur, viewed axially, was recorded with a video camera, and digitised computer images were produced. The outline of the intercondylar notch was extracted and represented mathematically as two functions. A functional principal components analysis was used to identify important modes of shape variation. These variations in shape were compared between eburnated and noneburnated femora. Results-A statistically significant diVerence in the shape of the intercondylar notch was found between the two groups. The diVerence related mostly to the shape of the edge of the medial condyle: in the non-osteoarthritic group this tended to exhibit a concavity; in the osteoarthritic group it tended to be straight. Conclusions-This observed diVerence may be a predisposing factor to the development of osteoarthritis. The morphology of the intercondylar notch is related to the functioning of and possible damage to the cruciate ligaments, and damage to the cruciate ligaments is a known risk factor for osteoarthritis. Alternatively, this difference may be due to bony remodelling secondary to the onset of osteoarthritis, perhaps in response to altered biomechanics. (Ann Rheum Dis 2001;60:968-973) Osteoarthritis (OA) of the knee is a common, painful, and debilitating condition. It aVects up to 30% of Western populations over the age of 65, 1 presenting a large burden for healthcare services.

Cruciate ligament laxity and femoral intercondylar notch narrowing in early‐stage knee osteoarthritis

“…Because our further preliminary work revealed that knees from some 42-week-old guinea pigs lacked the ACL entirely, it is likely that notch width narrowing causes impingement and damage of the ACL, as seen in humans. Our findings are therefore consistent with the hypotheses of Wada et al (10) and of Shepstone et al (23), that osteophyte formation is an event secondary to the onset of OA and a result of ACL laxity. This study is the first to show the time course of events involving ACL function and notch impingement in a way that has not been possible in humans.…”

“…Narrowing of the intercondylar notch has also been associated with OA severity (10,23) and deterioration of the ACL (10,22). Wada et al (10) and Shepstone et al (23) reported a significantly reduced NWI in the setting of moderate-to-severe OA.…”

“…Wada et al (10) and Shepstone et al (23) reported a significantly reduced NWI in the setting of moderate-to-severe OA. Wada et al (10) and Hernigou and Garabedian (22) reported that patients with a lax or missing ACL had a lower NWI compared with normal controls.…”

An Atlas-Based Approach to Study Morphological Differences in Human Femoral Cartilage Between Subjects from Incidence and Progression Cohorts: MRI Data from Osteoarthritis Initiative

“…In figure 5, higher mean and standard deviation of the deformation values are realized on the patellofemoral compartment of the trochlear (femoral) side. Previous distal femoral bone studies have indicated that shape changes in the intercondylar notch when comparing normal against diseased subjects as a discriminant of OA (Shepstone et al, 2001) and hence has there is a possibility of a potential link between the findings of this study to what has been observed in the past.…”

Is axial shape of distal femur different in normal and osteoarthritic female patients?

“…Wada et al [13] concluded that the intercondylar notch of the knee is significantly smaller in knees with severe OA relative to normal knees. Shepstone et al [14] studied human skeletons and created video images of an axial view of the distal femur and found that a flattened shape to the intercondylar notch of the femur was associated with the presence of late-stage OA. Therefore, it is reasonable to assess the relationship between the morphology of the intercondylar notch and OA.…”