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Early Changes of Trabecular Bone Structure in Asymptomatic Subjects With Knee Malalignment

Baum, Thomas MD; Sauerschnig, Martin MD; Penzel, Julia MD; Jungmann, Pia M. MD; Waldt, Simone MD; Rummeny, Ernst J. MD; Wörtler, Klaus MD; Bauer, Jan S. MD

Journal of Computer Assisted Tomography: January/February 2014 - Volume 38 - Issue 1 - p 137–141
doi: 10.1097/RCT.0b013e3182a90f08
Musculoskeletal Imaging

Objective To investigate whether alterations of trabecular bone structure can already be found in young asymptomatic subjects with knee malalignment.

Methods Forty-eight subjects with neutral, mild varus, severe varus, and valgus knee joint alignment were included in this study (12 subjects in each group). Histomorphometric and texture parameters of the trabecular bone in the medial/lateral femur/tibia were determined using 1.5-T magnetic resonance imaging.

Results Apparent trabecular thickness in the medial tibia compartment was lower in the valgus group (mean ± standard error, 0.353 ± 0.012 mm) compared with the neutral (0.396 ± 0.011 mm; P = 0.043), mild varus (0.403 ± 0.011 mm; P = 0.038) and severe varus groups (0.416 ± 0.013 mm; P = 0.015). In the medial femur compartment, fractal dimension was significantly greater in the mild (1.697 ± 0.005; P = 0.015) and severe varus groups (1.698 ± 0.005; P = 0.036) than in the valgus group (1.674 ± 0.005).

Conclusions The observed findings may be signs of the adaptation of the subchondral bone to altered loading conditions and possibly of early knee joint impairment.

From the *Institut für Radiologie, †Klinik und Poliklinik für Unfallchirurgie, ‡Klinik für Orthopädie und Sportorthopädie, and §Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität München, München, Germany.

Received for publication April 12, 2013; accepted August 12, 2013.

Reprints: Thomas Baum, MD, Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger St 22, 81675 München, Germany (e-mail:

Supported in part by grants of the Deutsche Forschungsgemeinschaft (DFG BA 4085/1-2).

The authors declare no conflict of interest.

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