Association Between Spinopelvic Sagittal Alignment and Femoral Cartilage Thickness in Knee Osteoarthritis: An Ultrasound-Based Observational Study
DOI:
https://doi.org/10.58600/eurjther2828Keywords:
femoral cartilage, knee osteoarthritis, lumbar lordosis, pelvic incidence, spinopelvic alignment, ultrasonographyAbstract
Objective: Altered sagittal spinopelvic alignment may influence lower extremity joint loading, yet its relationship with femoral cartilage morphology in knee osteoarthritis (KOA) remains unclear. This study aimed to investigate the association between sagittal spinopelvic parameters and femoral cartilage thickness in individuals with symptomatic KOA using high-resolution ultrasonography (USG).
Methods: A total of 87 patients with symptomatic KOA, diagnosed per American College of Rheumatology criteria, were prospectively evaluated. Spinopelvic parameters—including pelvic incidence (PI), lumbar lordosis (LL), and PI–LL mismatch—were measured via lateral standing radiographs. Femoral cartilage thickness at the medial, intercondylar, and lateral compartments was assessed bilaterally using standardized musculoskeletal USG. Correlations were analyzed using Pearson’s test and multivariate linear regression, with subgroup analysis based on PI–LL mismatch thresholds.
Results: PI–LL mismatch showed a weak negative correlation only with right intercondylar femoral cartilage thickness (r = –0.203, p = 0.044), while no significant correlations were found with medial or lateral compartments (all p > 0.050). Multivariate regression analysis confirmed LL as an independent predictor of left medial femoral cartilage thickness (p = 0.042), accounting for 7.8% of the variance. Each one-degree increase in LL was associated with a 0.012 millimeter increase in medial femoral cartilage thickness of the left knee. No significant associations were found between PI or LL alone and cartilage thickness in other compartments.
Conclusion: Increased PI–LL mismatch is associated with focal femoral cartilage thinning in KOA. These findings suggest that sagittal imbalance may affect joint morphology distal to the spine. Combined assessment of spinopelvic alignment and ultrasonographic cartilage thickness may offer added value in early-stage KOA evaluation and biomechanical risk stratification.
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Copyright (c) 2025 Ömer Faruk Bucak, Adil Öncel, Merve Çalkın Korkmaz, Sena Tolu
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