Lokoregionäre Deformationsmuster im Patellarknorpel nach unterschiedlichen Belastungsparadigmen – hochauflösende 3-D-MR-Volumetrie bei 3 T in vivo

PURPOSE: To analyze locoregional deformation patterns indicative of contact areas in patellar cartilage after different loading exercises. MATERIALS AND METHODS: 7 healthy patellae were examined in-vivo before and immediately after standardized loading (kneeling, squatting or knee bends) and after 90 minutes of rest using a sagittal 3D-T1-w FLASH WE sequence (22 msec/ 9.8 msec/ 15°/ 0.3 × 0.3 × 1.5 mm³) at 3 T. After cartilage segmentation and 3D reconstruction, voxel-based and global precision errors (PR) were calculated. The former were used to determine significant differences in local cartilage thickness. Voxel-based 2σ-thickness difference maps were calculated to visualize locoregional deformation patterns. Global changes in volume (Vol), mean thickness (mTh) and cartilage-bone-interface area (CBIA) were calculated. RESULTS: The voxel-based PR depended on cartilage thickness (D) ranging from 0.12 - 0.35 mm. For D ≥ 1 mm the RF was < 0.31 mm (< voxel size), and for D ≥ 2 mm, the RF was < 0.22 mm. The global PR was 83 mm³ (2.4 %) for Vol, 0.06 mm (2.0 %) for mTh and 16 mm² (1.4 %) for CBIA. The focal cartilage deformation equaled 14 % of the local thickness reduction. The deformation areas were oval and located in the peripheral medial (more vertically oriented, all exercises) and caudo-lateral (more horizontally oriented, kneeling and knee bends) aspects of the patella and were least pronounced in knee bends. Significant changes for Vol/mTh ranged from 2.1 to 3.7 %. CONCLUSION: This MRI-based study is the first to identify in-vivo voxel-based patellar cartilage deformation patterns indicating contact and loading zones after kneeling and squatting. These zones are anatomically and functionally plausible and may represent areas where stress induced degeneration and subsequent OA can originate. The data may facilitate understanding of individual knee loading properties and help to improve and validate biomechanical models for the knee.