N. Spoelder , W. Wirth , T.D. Turmezei , F. Eckstein , D.A. Kessler , J.W. Mackay , M. Karperien , S.C. Mastbergen , M.P. Jansen
{"title":"与性别相关的股胫软骨厚度差异的地形:一个匹配的男性-女性配对分析,控制年龄,bmi和身高","authors":"N. Spoelder , W. Wirth , T.D. Turmezei , F. Eckstein , D.A. Kessler , J.W. Mackay , M. Karperien , S.C. Mastbergen , M.P. Jansen","doi":"10.1016/j.ostima.2025.100350","DOIUrl":null,"url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Knee OA is both more common and progresses faster in women than in men. While it is well known that men exhibit thicker cartilage, it remains unclear whether this difference is inherently sex-based or attributable to confounding factors such as age, BMI, and/or height.</div></div><div><h3>OBJECTIVE</h3><div>The aim of this study was to evaluate regional differences in knee cartilage thickness between men and women without radiographic OA, who were matched for age, BMI, and height.</div></div><div><h3>METHODS</h3><div>Participants without radiographic signs of knee OA were selected from the Osteoarthritis Initiative (OAI). Men and women were matched based on height (±1 cm), age (±5 years), and BMI (±2 kg/m²), yielding 63 male-female pairs (n = 126; mean age 57 ± 8 years, BMI 26 ± 4 kg/m², height 170 ± 5 cm). Right knee 3T MRI scans were processed using a deep learning model to generate preliminary automatic segmentations of the outer femoral and tibial contours and the inner cartilage boundaries. These segmentations were manually refined in Stradview and converted into 3D surface models. Cartilage thickness was computed at each vertex as the distance from the cartilage surface to the underlying bone, measured along the normal vector using model-based deconvolution. The femoral, medial tibial, and lateral tibial surfaces and their associated thickness maps were spatially aligned to canonical templates using wxRegSurf. Statistical analyses were performed in MATLAB using the SurfStat package, applying statistical parametric mapping (SPM) with linear mixed models to evaluate paired male-female differences. Significance was set at p < 0.05.</div></div><div><h3>RESULTS</h3><div>Figure 1 shows the average cartilage thickness in men and women, as well as the differences between sexes. The difference map is predominantly blue, indicating thicker cartilage in men. In both sexes, cartilage was thicker on the lateral side than on the medial side. The trochlea had the greatest thickness overall, with a maximum of 3.98 mm in men and 3.30 mm in women. Statistically significant differences in cartilage thickness between men and women were observed in specific regions of the femur, medial tibia, and lateral tibia (Figure 2). In those regions in the femur, cartilage was thicker in men, with a mean thickness of 2.77 mm compared to 2.42 mm in women, a difference of 0.36 mm (15%). In both the statistically significant different regions of the medial and lateral tibia, cartilage thickness was 0.09 mm (4%) greater in men than in women, with means of 2.26 mm versus 2.17 mm and 2.19 mm versus 2.10 mm, respectively.</div></div><div><h3>CONCLUSION</h3><div>Despite similar height, age, and BMI, men exhibited thicker femorotibial cartilage than women. Statistically significant differences were found across all three joint surfaces, with the largest difference observed in the trochlea. These findings underscore the need for further research into sex-related differences in femorotibial cartilage thickness as a potential contributor to the greater prevalence and severity of knee OA in women.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 ","pages":"Article 100350"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"TOPOGRAPHY OF SEX-RELATED FEMOROTIBIAL CARTILAGE THICKNESS DIFFERENCES: A MATCHED MALE-FEMALE PAIR ANALYSIS CONTROLLING FOR AGE, BMI, AND HEIGHT\",\"authors\":\"N. Spoelder , W. Wirth , T.D. Turmezei , F. Eckstein , D.A. Kessler , J.W. Mackay , M. Karperien , S.C. Mastbergen , M.P. Jansen\",\"doi\":\"10.1016/j.ostima.2025.100350\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>INTRODUCTION</h3><div>Knee OA is both more common and progresses faster in women than in men. While it is well known that men exhibit thicker cartilage, it remains unclear whether this difference is inherently sex-based or attributable to confounding factors such as age, BMI, and/or height.</div></div><div><h3>OBJECTIVE</h3><div>The aim of this study was to evaluate regional differences in knee cartilage thickness between men and women without radiographic OA, who were matched for age, BMI, and height.</div></div><div><h3>METHODS</h3><div>Participants without radiographic signs of knee OA were selected from the Osteoarthritis Initiative (OAI). Men and women were matched based on height (±1 cm), age (±5 years), and BMI (±2 kg/m²), yielding 63 male-female pairs (n = 126; mean age 57 ± 8 years, BMI 26 ± 4 kg/m², height 170 ± 5 cm). Right knee 3T MRI scans were processed using a deep learning model to generate preliminary automatic segmentations of the outer femoral and tibial contours and the inner cartilage boundaries. These segmentations were manually refined in Stradview and converted into 3D surface models. Cartilage thickness was computed at each vertex as the distance from the cartilage surface to the underlying bone, measured along the normal vector using model-based deconvolution. The femoral, medial tibial, and lateral tibial surfaces and their associated thickness maps were spatially aligned to canonical templates using wxRegSurf. Statistical analyses were performed in MATLAB using the SurfStat package, applying statistical parametric mapping (SPM) with linear mixed models to evaluate paired male-female differences. Significance was set at p < 0.05.</div></div><div><h3>RESULTS</h3><div>Figure 1 shows the average cartilage thickness in men and women, as well as the differences between sexes. The difference map is predominantly blue, indicating thicker cartilage in men. In both sexes, cartilage was thicker on the lateral side than on the medial side. The trochlea had the greatest thickness overall, with a maximum of 3.98 mm in men and 3.30 mm in women. Statistically significant differences in cartilage thickness between men and women were observed in specific regions of the femur, medial tibia, and lateral tibia (Figure 2). In those regions in the femur, cartilage was thicker in men, with a mean thickness of 2.77 mm compared to 2.42 mm in women, a difference of 0.36 mm (15%). In both the statistically significant different regions of the medial and lateral tibia, cartilage thickness was 0.09 mm (4%) greater in men than in women, with means of 2.26 mm versus 2.17 mm and 2.19 mm versus 2.10 mm, respectively.</div></div><div><h3>CONCLUSION</h3><div>Despite similar height, age, and BMI, men exhibited thicker femorotibial cartilage than women. Statistically significant differences were found across all three joint surfaces, with the largest difference observed in the trochlea. These findings underscore the need for further research into sex-related differences in femorotibial cartilage thickness as a potential contributor to the greater prevalence and severity of knee OA in women.</div></div>\",\"PeriodicalId\":74378,\"journal\":{\"name\":\"Osteoarthritis imaging\",\"volume\":\"5 \",\"pages\":\"Article 100350\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Osteoarthritis imaging\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S277265412500090X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Osteoarthritis imaging","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S277265412500090X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
TOPOGRAPHY OF SEX-RELATED FEMOROTIBIAL CARTILAGE THICKNESS DIFFERENCES: A MATCHED MALE-FEMALE PAIR ANALYSIS CONTROLLING FOR AGE, BMI, AND HEIGHT
INTRODUCTION
Knee OA is both more common and progresses faster in women than in men. While it is well known that men exhibit thicker cartilage, it remains unclear whether this difference is inherently sex-based or attributable to confounding factors such as age, BMI, and/or height.
OBJECTIVE
The aim of this study was to evaluate regional differences in knee cartilage thickness between men and women without radiographic OA, who were matched for age, BMI, and height.
METHODS
Participants without radiographic signs of knee OA were selected from the Osteoarthritis Initiative (OAI). Men and women were matched based on height (±1 cm), age (±5 years), and BMI (±2 kg/m²), yielding 63 male-female pairs (n = 126; mean age 57 ± 8 years, BMI 26 ± 4 kg/m², height 170 ± 5 cm). Right knee 3T MRI scans were processed using a deep learning model to generate preliminary automatic segmentations of the outer femoral and tibial contours and the inner cartilage boundaries. These segmentations were manually refined in Stradview and converted into 3D surface models. Cartilage thickness was computed at each vertex as the distance from the cartilage surface to the underlying bone, measured along the normal vector using model-based deconvolution. The femoral, medial tibial, and lateral tibial surfaces and their associated thickness maps were spatially aligned to canonical templates using wxRegSurf. Statistical analyses were performed in MATLAB using the SurfStat package, applying statistical parametric mapping (SPM) with linear mixed models to evaluate paired male-female differences. Significance was set at p < 0.05.
RESULTS
Figure 1 shows the average cartilage thickness in men and women, as well as the differences between sexes. The difference map is predominantly blue, indicating thicker cartilage in men. In both sexes, cartilage was thicker on the lateral side than on the medial side. The trochlea had the greatest thickness overall, with a maximum of 3.98 mm in men and 3.30 mm in women. Statistically significant differences in cartilage thickness between men and women were observed in specific regions of the femur, medial tibia, and lateral tibia (Figure 2). In those regions in the femur, cartilage was thicker in men, with a mean thickness of 2.77 mm compared to 2.42 mm in women, a difference of 0.36 mm (15%). In both the statistically significant different regions of the medial and lateral tibia, cartilage thickness was 0.09 mm (4%) greater in men than in women, with means of 2.26 mm versus 2.17 mm and 2.19 mm versus 2.10 mm, respectively.
CONCLUSION
Despite similar height, age, and BMI, men exhibited thicker femorotibial cartilage than women. Statistically significant differences were found across all three joint surfaces, with the largest difference observed in the trochlea. These findings underscore the need for further research into sex-related differences in femorotibial cartilage thickness as a potential contributor to the greater prevalence and severity of knee OA in women.