Ömer Faruk BUCAK, Adil ÖNCEL, Merve ÇALKIN KORKMAZ, Sena TOLU
European Journal of Therapeutics - 2026;32(1):59-69
Objective: Altered sagittal spinopelvic alignment may influence lower extremity joint loading, yet its relationship with femoral cartilage morphology in knee osteoarthritis (KOA) remains unclear. This study aimed to investigate the association between sagittal spinopelvic parameters and femoral cartilage thickness in individuals with symptomatic KOA using high-resolution ultrasonography (USG). Methods: A total of 87 patients with symptomatic KOA, diagnosed per American College of Rheumatology criteria, were prospectively evaluated. Spinopelvic parameters-including pelvic incidence (PI), lumbar lordosis (LL), and PI-LL mismatch-were measured via lateral standing radiographs. Femoral cartilage thickness at the medial, intercondylar, and lateral compartments was assessed bilaterally using standardized musculoskeletal USG. Correlations were analyzed using Pearson's test and multivariate linear regression. Results: PI-LL mismatch showed a weak negative correlation only with right intercondylar femoral cartilage thickness (r = -0.203, p = 0.044). Multivariate regression analysis confirmed LL as an independent predictor of left medial femoral cartilage thickness (p = 0.042). Conclusion: Increased PI-LL mismatch is associated with focal femoral cartilage thinning in KOA. These findings suggest that sagittal imbalance may affect joint morphology distal to the spine.
