title: Vastus medialis cross-sectional area is associated with patella cartilage defects and bone volume in healthy women.
abstract: OBJECTIVE
  Although vastus medialis and vastus lateralis are important muscular determinants of patellofemoral joint function, it is unclear how these muscles relate to the structure of the patellofemoral joint. The aim of this cross-sectional study was to determine the relationship between the vasti muscles and patella cartilage volume and defects and patella bone volume.
  
  
  METHODS
  One hundred and seventy-five women, aged 40-67 years, with no knee pain or clinical lower-limb disease had magnetic resonance imaging (MRI) of their dominant knee. The cross-sectional areas of the distal vastus medialis and lateralis were measured 37.5mm superior to the quadriceps tendon insertion at the proximal pole of the patella. Patella cartilage volume and defects and patella bone volume were measured from these images using validated methods.
  
  
  RESULTS
  There was no significant association between the distal vastus medialis cross-sectional area and patella cartilage volume. For every 1mm(2) increase in the distal vastus medialis cross-sectional area, there was an associated increased risk of patella cartilage defects [odds ratio (OR): 1.2; 95% confidence interval (CI) 1.004, 1.5; P=0.05], and an associated increase in patella bone volume (OR: 3.9; 95% CI 2.0, 5.8; P<0.001) after adjustment for potential confounders. There was no significant relationship between vastus lateralis cross-sectional area and measures of patella cartilage or bone.
  
  
  CONCLUSIONS
  An increased cross-sectional area of the distal portion of the vastus medialis muscle is associated with an increased risk of patella cartilage defects, and an increase in patella bone volume among healthy women. Although these results need to be confirmed in longitudinal studies, they suggest that an increase in the distal vastus medialis cross-sectional area is associated with structural change at the patellofemoral joint.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Central and Eastern Clinical School, Monash University, Melbourne, Victoria 3004, Australia.
authors.forename: P A
authors.initials: PA
authors.lastname: Berry
authors.forename: F S
authors.initials: FS
authors.lastname: Hanna
authors.forename: A J
authors.initials: AJ
authors.lastname: Teichtahl
authors.forename: A E
authors.initials: AE
authors.lastname: Wluka
authors.forename: D M
authors.initials: DM
authors.lastname: Urquhart
authors.forename: R J
authors.initials: RJ
authors.lastname: Bell
authors.forename: S R
authors.initials: SR
authors.lastname: Davis
authors.forename: F M
authors.initials: FM
authors.lastname: Cicuttini
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001842:Bone and Bones / Q000473:pathology*; D002356:Cartilage / Q000473:pathology*; D005260:Female; D006801:Humans; D007717:Knee / Q000473:pathology; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010329:Patella / Q000473:pathology*; D052097:Quadriceps Muscle / Q000033:anatomy & histology / Q000502:physiology*; D013223:Statistics as Topic