ArticleBMC musculoskeletal disorders2025
High bilateral bony symmetry in dysplastic and nondysplastic knees: a CT-based 3D evaluation.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSide-to-side comparisons of knee joints are commonly used in orthopaedic research and surgery because natural pairs provide strong internal control for genetic, developmental, and environmental factors. This approach generally assumes that the contralateral knee represents a healthy anatomical baseline. However, it remains unclear whether this assumption holds in the presence of trochlear dysplasia, a key risk factor for patellofemoral instability (PFI), as dysplasia may affect the degree of bilateral symmetry in knee morphology. This study aimed to quantify three-dimensional (3D) morphological bony symmetry of knee joints and evaluate the impact of trochlear dysplasia.
methodsBilateral Computed tomography (CT) scans from 187 subjects were analysed, including 137 without trochlear dysplasia, 37 with low-grade dysplasia, and 13 with high-grade dysplasia. Surface models of the distal femur, patella, and proximal tibia were generated using automated segmentation with manual refinement. Correspondence points (CPs) were established via rigid registration of mirrored left-side models to right-side counterparts, followed by non-rigid registration of the right-side models onto the aligned left-side models. Symmetry was quantified as Euclidean distances between CPs.
resultsMedian CP distances were 0.8 mm in nondysplastic femurs and tibiae (1st–99th percentile 0.2–2.0/2.1 mm) and 0.9 mm in dysplastic femurs and tibiae (1st–99th percentile 0.2–2.1/2.3 mm), indicating a high degree of bilateral symmetry. Localized asymmetries of approximately 2–3 mm were observed, although no consistent anatomical patterns were identified. Patellar asymmetry increased with dysplasia severity, although it was primarily due to loose bone fragments rather than true anatomical variation.
conclusionsBoth nondysplastic and dysplastic knees exhibit high bilateral bony symmetry. Although CP distances were slightly higher in dysplastic knees, femoral and tibial CP distances remained small (group-level 99th percentiles ≤ 2.3 mm) and are therefore likely clinically irrelevant.
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