Correlation between Cartilage Defects as Detected with Mri and X-ray Spiking of Tibial Tubercles in Osteoarthritis Knees

Objective: To ascertain whether spiking of the tibial tubercles is associated with cartilage defects as detected by magnetic resonance imaging (MRI) in osteoarthritis (OA) of the knee joint patients. Methodology: The study was performed on 76 knees of 47 patients with symptomatic tibiofemoral joint (TFJ) OA and 31 apparently normal knees of 16 volunteers as a control group. Angulation of the tip of the medial and lateral tubercles and the height of the tubercles above the tibial plateau were measured on a standard anteroposterior radiograph of the knee joint. Cartilage defects in the tibiofemoral joint were determined with MRI examination. Results: The lengthening and sharpening of the angles of the tubercles were significantly more prominent in patients than controls. A strong association was found between angulation (if less than 70) and especially the height (if more than 0.16) of the medial tibial spike and MRI-detected cartilage defects in the medial tibiofemoral compartment. The predictive value of the spiking of tibial tubercles for MRI-detected cartilage defects in TFJ was related to the degree and size of spiking. Conclusion: The presence of tibial spiking itself may not be a reliable sign of early OA.