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Age‐Based Degenerative Joint Disease of Intracapsular Anatomy of the Knee: A Cadaveric Study
Author(s) -
Immonen Jessica,
Siefring Chris,
Sanders Luke
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.901.1
Subject(s) - cadaveric spasm , medicine , osteoarthritis , knee joint , articular cartilage , age groups , degenerative disease , medial meniscus , joint disease , meniscus , articular surface , anatomy , surgery , central nervous system disease , incidence (geometry) , pathology , demography , physics , alternative medicine , sociology , optics
The objective of this study is to determine specific degenerative changes to intracapsular anatomy of the knee joint with aging. The Center for Disease Control states that approximately 14% of Americans 25–65 years old and 33.6% of Americans 65+ experience symptoms of osteoarthritis (OA) and/or degenerative joint disease. The knee joint heavily contributes to OA‐related deaths and hospitalizations in the United States and these values are likely underestimated. Metamorphic analyses to cadaveric intracapsular anatomy of the knee were performed using Image Pro software on three age populations: < 70 years old, 70–79 years old and greater than or equal to 80 years old. The articular cartilage of the medial tibial plateau in the greater than or equal to 80 years old specimens showed a 1.7‐fold increase in surface area degeneration (mm 2 ) compared to 70–79 years old specimens (P<0.05). The articular cartilage of the lateral tibial plateau experienced a 15% and 26% approximate loss in surface area when comparing the < 70 years old age group to the 70–79 years old age group and the greater than or equal to 80 years old age group, respectively. The medial meniscus experienced degenerative changes with aging. These values were expressed as decreases in tibial plateau surface area coverage. Specimens < 70 years old had an average of 49% coverage of the medial tibial plateau whereas the 70–79 years old and the greater than or equal to 80 years old age groups had approximately 38% and 36% coverage, respectively. No major degeneration with aging was seen on the lateral meniscus. 100% of the specimens contained either the anterior meniscofemoral ligament or the posterior meniscofemoral ligament. This additional support to the lateral meniscus could reduce its degeneration as well as the degeneration of underlying lateral articular cartilage. The anterior cruciate ligament (ACL) experienced substantial degenerative thinning with aging. The 70–79 years old specimens had a 1.2‐fold decrease in average ACL circumference (mm) compared to the < 70 years old specimens (P<0.001). The greater than or equal to 80 years old specimens had a 1.24‐fold decrease in ACL circumference compared to the < 70 years old specimens (P<0.001). Weakness of the tensor fascia lata muscle, excessive foot pronation during gait, obesity and skeletal pathology such as shortening or fracture of the femur all may contribute to the increased lateral degeneration with aging on the tibial plateau compared to the medial respects. Contrarily, the medial respects of the joint may experience accelerated degeneration of the meniscus and articular cartilage due to normal compressive forces during gait and obesity. ACL thinning during aging may be leading to substantial articular cartilage degeneration given the cruciate ligaments and the musculature of the knee joint are the primary restraints that combat shearing forces at the knee joint. Support or Funding Information Internal Grant from RMUoHP for Protocol No. 150430‐04