Femoral Chondral Lesions Increase in Severity with Aging Equally Between the Sexes and Present in Comparable Locations
Authors: Immonen Jessica , Albin Alexa , Hansen Andrew , Stevens Kelsey , Gilmer Les , Zdilla Matthew 
Published: June 2021

Objective

The objective of this study was to determine if visible, femoral chondral lesions on cadaveric knee joints exacerbate differently with aging between the sexes.

Methods

85 cadaveric femurs were assessed for chondral pathology overlying the femoral condyles and patellar fossa using a 0–4 qualitative grading scale for gross signs of osteoarthritis (OA). Each specimen was blinded to four raters and the raters' scores were averaged to provide each specimen a Disease Severity Score (DSS).

Results

Specimens 80+ years old (N=22) had an average DSS of 3.19 ± 0.69 compared to a DSS of 2.7 ± 0.85 and a DSS of 2.52 ± 0.95 for specimens 70–79 years old (N=42) and specimens below 70 years old (N=22), respectively. The DSS for the 80+ years old population was significantly greater than the DSS of the 70–79 years old population (p < 0.05) and the below 70 years old population (p < 0.05). Specimens that scored a DSS of 2 and above, representing mild OA to severe OA, were assessed for their specific site of most severe degeneration. The most severe degeneration on the femoral articular cartilage was consistently on the patellar fossa. This degeneration was seen in 45% of specimens below 70 years old, 60% of specimens 70–79 years old and 50% of specimens above the age of 80 years old. The lateral condyle was the second most degenerated region in the below 70 years old specimens (27%). The medial condyle became the second most degenerated region in the 70–79 years old specimens (38%) and the above 80 years old specimens (68%). The males and females in the above 80 years old population each displayed a 2:7 ratio for lateral condyle vs. medial condyle as the site of most severe deterioration.

Conclusions

This study displayed increased severity of OA on the femoral condyles with aging yet, there was no difference between the sexes in the severity or location of degeneration. With increased propensity to develop shearing forces in the knee based on cruciate ligament thinning or muscular atrophy around the joint the medial joint can experience increased degeneration. Currently, over 2/3s of the American population is overweight and obesity sways tibiofemoral compression forces to the lateral respects of the joint. When patients are over the age of 80 their muscles supporting the joint have atrophied and can no longer resist degenerative shearing forces at the knee. Whereas patients between the ages of 70–79 appear to represent a split population where approximately half of this population may be affected by obesity and the other half by muscular atrophy. It is recommended that public health advisory committees target these patients earlier in adult life with recommendations to increase their muscle mass around the knee joint and reduce obesity. The most prevalent sites of degeneration per each age group should be considered as research on stem cell therapy for synovial joint pathology continues to increase.

Support or Funding Information

Internal grant from Rocky Mountain University of Health Professions

This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.