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Thesis Format



Master of Science




Pamukoff, Derek N.


The purpose was to examine (1) the effect of measurement position and sex on femoral cartilage outcomes, and (2) the association between gait biomechanics and cartilage outcomes. Fifty individuals participated (25 males, 25 females; Age=20.62±1.80years). Ultrasound measured femoral cartilage thickness and echo-intensity (EI) at 90º, 115º, and 140º of knee flexion. Gait outcomes included the external knee adduction and knee flexion moments. Cartilage outcomes were compared using 2(sex) x 3(position) repeated measures ANOVA. Gait and cartilage associations were assessed using stepwise regression. Cartilage was thicker when measured at 90° compared with 140°, but mainly in males. Males had thicker cartilage than females in all positions. EI was lower at 90° than 140° in the central and lateral regions. No association was found between gait and cartilage outcomes. Imaging position and sex influences cartilage outcomes and should be considered in study designs and clinical evaluation.

Summary for Lay Audience

Articular knee cartilage is the substance within the knee joint that allows the thigh to move over the shin and kneecap without pain. Thinner cartilage can contribute to diseases such as osteoarthritis which can reduce mobility and cause pain in the knee joint. Thus, assessing knee cartilage thickness is important when assessing knee health.

Ultrasound is a cost effective, accessible method of viewing cartilage about the femur. However, it is only able to view a portion of the joint due to the size of the ultrasound probe. Knee cartilage characteristics are not homogeneous throughout the joint. Thus, manipulating probe placement or the joint position during imaging may change the viewable region of cartilage.

Cartilage is affected by compressive forces within the knee during tasks like walking. Males and females have different walking patterns, which may have unique effects on knee cartilage characteristics.

This study had two aims. 1) evaluate the effect of sex (males and females) and knee position during imaging on femoral cartilage thickness and composition and 2) assess associations between walking patterns and these cartilage characteristics. We found thicker cartilage was observed when viewing the knee in a more extended position. Cartilage composition was also affected by measurement position. Next, we found that males had thicker cartilage than females across all measurement positions. We did not find any relationship between walking patterns and cartilage outcomes.

The findings from this study show that sex and knee position during ultrasound imaging influence knee cartilage measurements. Both variables should be considered by researchers and clinicians who use ultrasound to assess joint health.

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Creative Commons Attribution-Share Alike 4.0 License
This work is licensed under a Creative Commons Attribution-Share Alike 4.0 License.

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Biomechanics Commons