Ultrasound reference values for trochlear cartilage in healthy black African subjects: a study of a cohort of 506 participants

Ultrasound reference values for trochlear cartilage in healthy black African subjects: a study of a cohort of 506 participants | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Ultrasound reference values for trochlear cartilage in healthy black African subjects: a study of a cohort of 506 participants Aboubakar Ouédraogo, Safiatou Nikiéma/Ouédraogo, Yamyellé E. Zongo, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8747970/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 12 You are reading this latest preprint version Abstract Objective To establish ultrasound reference values for femoral trochlear cartilage thickness in healthy adults of Black African origin and identify factors influencing variation. Methods Cross-sectional study conducted at Bogodogo University Hospital (Burkina Faso) on 506 healthy participants (1,012 knees) aged 18 to 45 years. Thickness was measured by a single radiologist using an ultrasound scanner with a high-frequency linear probe (8–15 MHz) at the medial condyle (MC), lateral condyle (LC), and intercondylar zone (ICZ). Multiple linear regression was used to analyze the factors associated with variations in thickness. Results The population consisted of 408 men (80.63%) and 98 women (19.37%) with a mean age of 24.36 ± 3.42 years. The mean thickness was 2.36 mm at the MC, 2.38 mm at the LC, and 2.60 mm at the ICA. Bivariate analysis showed significantly thicker cartilage in men (p = 0.001). After multivariate adjustment, gender and weight remained positively associated with thickness (p < 0.001), while BMI showed a negative association. Age was no longer significantly associated in the final model. Conclusion This study provides the first ultrasound standards for trochlear cartilage in a sub-Saharan African population. These data constitute an essential paraclinical reference for the early detection of knee osteoarthritis and the interpretation of cartilage measurements in this geographical context. articular cartilage knee ultrasound sub-Saharan Africa Figures Figure 1 INTRODUCTION Articular cartilage is a highly specialized connective tissue covering the articular bone surfaces, allowing them to slide thanks to its low friction coefficient and its mechanical properties, elasticity, lubrication, and resistance to compressive forces. Its study is of major interest for the early diagnosis and treatment of osteoarthritis [ 1 ]. Osteoarticular and muscular disorders affect more than 1.7 billion people worldwide and are the leading cause of disability according to the World Health Organization (WHO) [ 2 ]. With a frequency of 365 million people affected, the knee is the joint most commonly affected by osteoarthritis, followed by the hand and hip [ 3 , 4 ]. The development of drugs capable of modifying the natural progression of osteoarthritis is a major research goal for scientists; imaging plays an important role in evaluating these treatments on cartilage [ 5 ]. Standard radiography provides an indirect assessment of articular cartilage but remains a source of radiation exposure [ 5 ]. Arthroscopic scanning allows direct, volumetric visualization of cartilage with good spatial resolution but is invasive [ 5 ]. Magnetic resonance imaging (MRI), considered the gold standard for assessing cartilage thickness, is expensive and has limited accessibility and availability [ 5 ]. Ultrasound is a non-invasive, accessible imaging modality for assessing articular cartilage [ 6 , 7 ]. It is a reliable and validated imaging technique for measuring femoral trochlear cartilage [ 8 , 9 ]. The ability to mobilize the knee and contract the quadriceps femoris muscle makes this joint an ideal site for measuring articular cartilage [ 7 ]. The articular cartilage of the femoral trochlea is visible, accessible without complex preparation, and allows for rapid and reproducible bilateral assessment in routine clinical practice [ 7 ]. Knowledge of normal articular cartilage thickness values allows for early detection of osteoarthritic lesions [ 10 , 11 ]. Data from the literature on the average thickness of femoral trochlear cartilage show significant variations depending on geographical context. In Turkey, the study by Özçakar et al. established averages between 2 and 2.3 mm [ 12 ], results similar to those obtained by Babayeva et al. (2.1 to 2.2 mm) [ 13 ], Bedewi et al. in Saudi Arabia (1.95 to 2.17 mm) [ 14 ] and Herrera et al. in Colombia (1.9 to 2.3 mm) [ 15 ]. Conversely, lower measurements were documented in Indonesia by Pane et al., with averages ranging from 1.69 mm to 1.92 mm depending on the compartment [ 16 ]. Beyond these averages, several factors significantly influence the variability of this thickness. Gender and physical activity appear to be the most frequently reported determinants. Thicker cartilage is regularly observed in men and high-level athletes in several studies [ 12 , 13 , 15 – 17 ]. Other variables are also reported more heterogeneously, such as age, height, and smoking [ 12 , 14 , 18 – 20 ]; however, body mass index (BMI) does not appear to be systematically correlated with these variations [ 16 ]. All of these studies, conducted in Caucasian populations, have established reference values for the articular cartilage of the femoral trochlea and objectively demonstrated multifactorial variability in the thickness of this cartilage, particularly in relation to gender, age, various anthropometric parameters, and physical activity [ 12 , 14 – 16 ]. The scarcity of ultrasound studies on articular cartilage in black African populations contrasts with the preponderance of data from Caucasian populations and highlights the relevance of establishing reference values specific to this population [ 21 ]. The absence of established standards for this population raises a fundamental question: what are the normal values for femoral trochlear articular cartilage thickness, as measured by ultrasound, in healthy black African subjects? What factors may be associated with variation in the thickness of this cartilage? The main objective of our study was to establish reference values (normal values) for the thickness of the femoral trochlear cartilage, measured by ultrasound in healthy adults of black African origin. METHODS 1. Type and period of study This is a descriptive and analytical cross-sectional study conducted over a 6-month period from April 1 to September 15, 2025. The aim was to determine the ultrasound reference values for femoral trochlear cartilage thickness in healthy adults of African descent, while identifying the factors influencing its morphological changes. 2. Study setting The Rheumatology and Medical Imaging departments of the Bogodogo University Hospital Center (CHU-B) in Ouagadougou (Burkina Faso) served as the setting for the study. Burkina Faso is a country of 272,200 km² located in West Africa with an estimated population of 20,487,979 inhabitants [ 22 ]. 3. Study population The study population consisted of all healthy black African adults residing in Ouagadougou during the study period and meeting the inclusion criteria. 3.1. Sampling Participants were recruited on a convenience basis from among CHU-B staff, students interning at the hospital, police cadets receiving medical training as part of their medical visits, and CHU-B users. 3.2. Inclusion criteria Participants aged 18 to 45 years of age with no history of disease or current symptoms in the knees or pelvic limbs, who were admitted to the CHU-B during the study period and who gave their informed consent were included in the study. 3.3. Exclusion criteria Participants being treated for knee joint cartilage disease (inflammatory or degenerative), autoimmune disease, or rheumatic diseases were not included in the study. The same applied to participants with a history of surgery or trauma to the knee or pelvic limb, a static disorder of the pelvic limbs, or who had already undergone knee infiltration. 4. Study procedure After obtaining informed consent from participants and conducting a complete clinical examination, a suprapatellar cross-section of both knees was performed on a patient lying supine on an examination table with the knee flexed to the maximum (Fig. 1 ). A SIEMENS ACUSON NX3 Elite ultrasound machine with a high-frequency linear probe (8 to 15 MHz) was used. The ultrasound was performed by the same radiologist for all participants. The trochlear cartilage was measured on both femoral condyles and the intercondylar area (Fig. 1 ). 5. Study variables Socio-demographic data (age, gender), anthropometric data (height, weight, body mass index), and lifestyle (physical activity) were the independent variables in our study. BMI (in kg/m²) was interpreted according to WHO classifications [ 23 ]. The level of physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) score (short version) [ 24 ]. Ultrasound data (measurement of the thickness of the articular cartilage of the medial and lateral condyles and the intercondylar area of the knees) constituted the dependent variables. 6. Data collection and analysis 6.1. Data collection Data were collected using a standardized survey form administered directly to participants. This tool was used to collect the sociodemographic, anthropometric, and ultrasound information needed for the study. 6.2. Statistical analysis Data processing and analysis were performed using STATA software (version 14.0). Quantitative variables are expressed as means accompanied by their standard deviations and extreme values (min–max). Qualitative variables are presented as numbers and percentages. Correlations between measurements of the femoral trochlear cartilage (at the medial condyle (MC), lateral condyle (LC), and intercondylar zone (ICZ)) and socio-demographic and anthropometric variables and level of physical activity were analyzed using Pearson's or Spearman's correlation test depending on the distribution of the variables for quantitative variables and Student's t-test for qualitative variables. For all analyses, the statistical significance threshold was set at p ≤ 0.05. In order to identify the factors associated with the thickness of the femoral trochlear articular cartilage, a multiple linear regression (calculation of the beta coefficient with the p-value) was performed between the dependent variable and the independent variables. Adjustments and modeling were then performed with those that had a p ≤ 0.05. This allowed us to obtain the association coefficient β, which varies between − 1 (negative association) and + 1 (positive association), passing through 0 (no association). The closer the absolute value of the coefficient β is to 1, the stronger the association. The variables with a p ≤ 0.05 were retained as factors associated with the thickness of the femoral trochlear articular cartilage. 7. Ethical considerations The protocol was validated by the CHU-B institutional ethics committee by deliberation No. 2025-01-03 of March 25, 2025. The confidentiality and anonymity of participants were respected throughout our study. Written informed consent was obtained from each volunteer invited to participate in the study prior to enrollment. The study was conducted in accordance with the Declaration of Helsinki [ 25 ]. 8. Declaration of generative ai and ai-assisted technologies in the writing process Generative AI was used to improve the clarity of several sentences in this manuscript. During the preparation of this work the author used Gemini in order to check clarity and readability of several sentences. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication. RESULTS 1. Population characteristics Five hundred and six participants took part in the study. Ultrasound measurements of trochlear cartilage were performed on 1,012 knees. The participants included 408 men (80.63%) and 98 women (19.37%), with a sex ratio of 4.16. The mean age was 24.36 ± 3.42 years, with extremes of 19 and 45 years. Table 1 shows the general characteristics of the study population. Table 1 General characteristics of the study population and ultrasound measurement of articular cartilage Variables Mean ± Standard deviation Extremes Number (n = 506) Percentage Height (cm) 174,95 ± 5,42 [154–196] NA NA Weight (kg) 70,28 ± 8,47 [44,65–126,3] NA NA BMI (kg/m²) 22,94 ± 2,64 [16–42,69] NA NA Underweight 11 2,17 Normal weight 420 83,00 Overweight 64 12,65 Moderate obesity 8 1,58 Severe obesity 1 0,20 Morbid obesity 2 0,40 Level of physical activity (IPAQ score) High level NA NA 397 78,46 Moderate level NA NA 68 13,44 Low level NA NA 41 8,1 Cartilage thickness Right knee CM 2,34 ± 0,46 [1, 1–3, 8] NA NA ZIC 2,61 ± 0,61 [1, 2–5, 6] NA NA CL 2,42 ± 0, 47 [1,2 6 − 4,40] NA NA Left knee CM 2,37 ± 0,50 [1, 2–4, 20] NA NA ZIC 2,60 ± 0,62 [1,00–5,30] NA NA CL 2,34 ± 0,47 [1,01–4,01] NA NA 2. Ultrasound measurements of cartilage The mean thickness of the femoral trochlear articular cartilage measured at the medial condyle (MC) of the knees was 2.36 mm, with extremes of 2.36 mm and 8 mm. The mean thickness of the lateral condyle (LC) was 2.38 mm, with extremes of 2.21 mm and 8.41 mm. The average thickness of trochlear cartilage measured at the intercondylar zone (ICZ) was 2.60 mm, with extremes of 2.20 mm and 10.9 mm. Table 1 summarizes the average thickness of trochlear cartilage measured according to knee and anatomical zone. 3. Analytical study 3.1. Bivariate analysis The analysis showed that the average cartilage thickness was significantly higher in men than in women at all measurement sites (p = 0.001). In the right knee, measurements in men were 2.39 ± 0.46 mm (MC), 2.49 ± 0.47 mm (LC), and 2.71 ± 0.60 mm (ZIC), compared to 2.14 ± 0.4 mm, 2.14 ± 0.37 mm, and 2.21 ± 0.49 mm in women, respectively. The averages observed in the left knee were 2.43 ± 0.50 mm (CM), 2.40 ± 0.46 mm (CL) and 2.70 ± 0.61 mm (ZIC), while in women they were 2.12 ± 0.41 mm (CM), 2.05 ± 0.39 mm (CL) and 2.17 ± 0.45 mm (ZIC). All of these bivariate analyses are summarized in Table 2. Table 2. Summary of bivariate analyses Physical activity (IPAQ score) Cartilage thickness (mm) Age (years) Weight (kg) BMI (kg/m²) Low level Moderate level High level Correlation (r) p-value Correlation (r) p-value Correlation (r) p-value Average Average Average p-value Right knee CM - 0,100 0,02 0,144 0,001 0,058 0,194 2,37 2,25 2,36 0,1975 ZIC -0,141 0,001 0,213 <0,001 0,122 0,006 2,55 2, 39 2,65 0,0030 CL -0,097 0,03 0,226 <0,001 0,177 <0,001 2,44 2, 32 2,43 0,1781 Left knee CM -0,064 0,15 0,190 <0,001 0,111 0,012 2,38 2,27 2,39 0,2116 ZIC -0,092 0,04 0,220 <0,001 0,136 0,002 2,47 2,32 2,66 0,0001 CL -0,037 0,41 0,186 <0,001 0,116 0,009 2,30 2,26 2,35 0,3099 BMI: body mass index, MC medial condyle; LC lateral condyle; ZIC intercondylar zone 3.2. Multivariate analysis Multiple linear regression was performed to assess the association between femoral trochlear articular cartilage thickness and the various independent variables. In the initial model, the β coefficient associating gender with cartilage thickness varied between 0.196 and 0.481 depending on the compartments measured, with constant statistical significance (p < 0.001). After adjustment and final modeling, the β coefficient for gender then varied between 0.207 and 0.532 for all compartments (p < 0.001). There is an association between gender and cartilage thickness, independent of the other variables included in the model. Table 3 presents a detailed summary of these multivariate analyses. Table 3 Detailed summary of these multivariate analyses. Variables Cartilage thickness * β coefficient p-value CMD ZICD CLD CMG ZICG CLG Initial model Final model Initial model Final model Initial model Final model Initial model Final model Initial model Final model Initial model Final model Age -0,009 0,145 -0,020 0,014 -0,018 0,165 -0,011 0,071 -0,002 0,676 -0,008 0,299 0,012 0,849 Gender 0,196 0,002 0,207 < 0,001 0,407 < 0,001 0,471 < 0,001 0,313 < 0,001 0,342 < 0,001 0,262 < 0,001 0,274 < 0,001 0,481 < 0,001 0,532 < 0,001 0,377 < 0,001 0,357 < 0,001 Weight 0,052 0,009 0,053 0,008 0,021 0,418 -0,001 0,950 0,0777 < 0,001 0,079 < 0,001 0,038 0,134 0,052 0,009 0,050 0,011 BMI -0,142 0,019 − 0,147 0,014 -0, 027 0,725 0,038 0,530 -0,205 0,002 -0,213 0,001 -0,082 0,291 -0,139 0,021 -0,131 0,028 BMI: body mass index, MC medial condyle; LC lateral condyle; ZIC intercondylar zone DISCUSSION Our study, conducted on a sample of 1,012 knees, establishes the first normative values for femoral trochlear cartilage thickness by ultrasound in young, healthy subjects in sub-Saharan Africa. Our results reveal a variation in cartilage thickness depending on the anatomical area explored, with respective averages of 2.36 mm at the medial condyle, 2.38 mm at the lateral condyle, and a maximum thickness of 2.60 mm at the intercondylar area. These results could provide a necessary reference for clinical practice for accurate and optimal interpretation of ultrasound measurements of articular cartilage in this specific population. Furthermore, our analysis highlights that factor such as gender, weight and, to a lesser extent, age and level of physical activity influence cartilage morphology, both globally and compartmentally. The study of normal cartilage suggests the selection of a young population. In our study, the average age of the population was 24.36 ± 3.42 years. This finding has been observed in several studies of articular cartilage in healthy populations. Indeed, Herrera et al. in Colombia, Bedewi et al. in Saudi Arabia, Özçakar et al. in Turkey, and Pane et al. in Indonesia found average ages of 20 ± 2.5 years, 30.60 years ± 6.13 years, 31.7 years ± 4.8 years, and 32.83 years ± 13.67 years [ 12 , 15 , 16 , 26 ]. However, Roberts et al. in the United Kingdom reported an average age of 43 years ± 18 years, which is higher than ours [ 8 ]. Selecting a young population is the best way to avoid the presence of degenerative lesions that appear after the age of 40 and can impact the measurement of cartilage thickness [ 4 ]. The average thickness of trochlear cartilage observed in our study, all compartments combined, was comparable to the values reported by Özçakar et al. in Turkey [ 12 ]. However, our measurements are higher than those documented by Roberts et al. in the United Kingdom, Bedewi et al. in Saudi Arabia, and Pane et al. in Indonesia (Table 4 ) [ 8 , 14 , 16 ]. This disparity could be attributed to the relative youth of our sample, as well as the fact that the vast majority of our participants were involved in intensive sports activities. The influence of ethnic origin could also be cited as a contributing factor, although this hypothesis needs to be confirmed by a subsequent comparative study between Caucasian and Black African populations. Table 4 Comparative table of ultrasound reference values for trochlear cartilage in healthy subjects Studies Average cartilage thickness according to compartment measured in mm Study population size Sex ratio Right knee Left knee MC ZIC LC MC ZIC LC Our study Burkina Faso 2025 2,34 ± 0,46 2,61 ± 0,61 2,42 ± 0,47 2,37 ± 0,50 2,60 ± 0,62 2,34 ± 0,47 506 4,16 Pane et al. 2022 (Indonésie) 1,76 ± 0,33 1,92 ± 0,39 1,71 ± 0,31 1,76 ± 0,34 1,9 ± 0,33 1,89 ± 0,34 127 0,44 Bedewi et al. 2020 (Saudi Arabia) 2,0 ± 0.04 2,1 ± 0.04 2,0 ± 0,03 1,9 ± 0,04 2,1 ± 0,05 2,3 ± 0,03 72 1 Roberts et al. 2019 (United Kingdom) 1,86 ± 0,30 2,07 ± 0,43 1,87 ± 0,30 1,78 ± 0,34 2,08 ± 0,41 1,76 ± 0,32 77 2,50 Özçakar et al. 2014 (Turkey) 2,20 ± 0,50 2,30 ± 0,60 2,20 ± 0,50 2,20 ± 0,50 2,30 ± 0,60 2,20 ± 0,50 1438 1,31 MC medial condyle; LC lateral condyle; ZIC intercondylar zone In our study, bivariate analysis initially revealed a positive correlation between gender, anthropometric variables (weight, BMI), and trochlear articular cartilage thickness, while a negative correlation was observed with age. However, after adjustment by multiple linear regression, only gender and weight maintained an independent positive association with cartilage thickness. Conversely, BMI showed a negative association. The absence of a significant association between age and cartilage thickness in multivariate analysis is consistent with the work of Bedewi et al. and Pane et al. [ 14 , 16 ]. Although the literature typically reports a decrease in cartilage thickness with aging, age is a non-modifiable risk factor for osteoarthritis [ 18 – 20 , 27 ]. Our results could be explained by the relative youth and homogeneity of our sample. The age range was probably not sufficient to detect the structural effects of aging, which generally become apparent after the age of 40 [ 4 ]. Gender is the most consistently found factor influencing the variability of femoral trochlear cartilage thickness. In line with almost all of the literature, we observed greater thickness in male subjects [ 8 , 12 , 14 , 16 – 18 ]. While the role of sex hormones is often mentioned, the exact pathophysiological mechanisms remain to be elucidated [ 28 ]. It should be noted that this gender disparity is also described in prepubescent children by Gau et al. and Spannow et al., suggesting that, in addition to biological factors, physical activity and environmental factors play a crucial role in cartilage development from an early age [ 19 , 20 , 28 ]. The link between weight and cartilage thickness is controversial in the literature: while Babayeva et al. and Roberts et al. confirm this correlation [ 8 , 13 ], this finding has not been made by Özçakar et al., Bedewi et al., or Pane et al. [ 12 , 14 , 16 ]. From a biomechanical perspective, excess weight increases joint stress, ultimately promoting harmful remodeling and thinning of the cartilage [ 27 ]. This observation is consistent with the negative association between high BMI and cartilage thickness found in our study and is in line with the work of Roberts et al., Amber et al., and Collins et al., who highlight the harmful influence of obesity on knee cartilage [ 8 , 29 , 30 ]. However, the overall preservation (or even increase) in cartilage thickness in our population could be explained by the specific profile of the participants: 83% had a normal BMI and 91.9% engaged in regular physical activity. This active lifestyle promotes protective muscle mass and optimal weight modulation. Our study had limitations that should be taken into account when interpreting our results. The classic limitations of data interpretation in cross-sectional studies may apply to our study. A potential selection bias should be considered due to the convenience sampling (non-probabilistic) recruitment method. This approach could limit the representativeness of the sample in relation to the general population and, consequently, restrict the generalizability of our conclusions. In addition, the ultrasound was performed by a single sonographer, which may have introduced measurement bias. Nevertheless, our examination protocol was rigorously standardized to minimize this impact. CONCLUSION This study proposes the first normative ultrasound values for femoral trochlear cartilage in a population of young, healthy subjects in sub-Saharan Africa. By precisely quantifying cartilage thickness and identifying factors that influence variation, such as weight, gender, and BMI, this work provides an essential reference for regional clinical and radiological practice. However, these results are a first step that calls for further investigation. Validation of these measurements by reference imaging techniques, such as MRI, will be a crucial step in consolidating the reliability of the ultrasound tool. Finally, the deployment of longitudinal studies would allow for better characterize the dynamics of cartilage evolution and identify early markers of degeneration. Declarations ETHICS APPROVAL AND CONSENT TO PARTICIPATE The protocol was validated by the CHU-B institutional ethics committee by deliberation No. 2025-01-03 of March 25, 2025. The confidentiality and anonymity of participants were respected throughout our study. Written informed consent was obtained from each volunteer invited to participate in the study prior to enrollment. The study was conducted in accordance with the Declaration of Helsinki [25]. CONSENT FOR PUBLICATION Not applicable AVAILABILITY OF DATA AND MATERIALS Data supporting the results of this study are available from the corresponding author on reasonable request COMPETING INTERESTS The authors declare that they have no competing interests FUNDING This work did not receive any funding of any kind. AUTHORS' CONTRIBUTIONS A.O : Contributing to the conceptualization, the data curation, the methodology, the formal analysis, the supervision, the validation and the writing of the original draft. S.N/O : Contributing to the conceptualization, the data curation and the methodology. Y.E.Z: Contributing to the conceptualization, the data curation the methodology, the supervision, the validation and the writing of the original draft. A.S.I/K : Contributing to the conceptualization, the methodology, the validation and the writing of the original draft. C.S : Contributing to the validation and the writing of the original draft. J.C/K : Contributing to the supervision, the validation and writing – review and editing. B.M.K/T : Contributing to the supervision, the validation and the writing of the original draft. J.W.S.T/Z : Contributing to the visualization, the validation and the writing of the original draft. D-D.O: Contributing to the validation and the writing of the original draft. ACKNOWLEDGEMENTS Not applicable AUTHORS' INFORMATION (OPTIONAL) Not applicable References Chevalier X, Richette P. Cartilage articulaire normal: anatomie, physiologie, métabolisme, vieillissement. EMC - Rhumatol-Orthopédie. janv. 2005;2(1):41–58. Organisation mondiale de la Santé. Affections ostéo-articulaires et musculaires [Internet]. Genève: Organisation mondiale de la Santé ; 14 juill 2022 [cité 26 déc 2025]. Disponible sur : https://www.who.int/fr/news-room/fact-sheets/detail/musculoskeletal-conditions Organisation mondiale de la Santé. Arthrose [Internet]. Genève: Organisation mondiale de la Santé ; 14 juill 2023 [cité 26 déc 2025]. Disponible sur : https://www.who.int/fr/news-room/fact-sheets/detail/osteoarthritis Steinmetz JD, Culbreth GT, Haile LM, Rafferty Q, Lo J, Fukutaki KG, et al. Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol sept. 2023;5(9):e508–22. Laredo JD. [New developments in cartilage imaging]. Bull Acad Natl Med oct. 2006;190(7):1459–73. discussion 1473–1477. Slimani S. Echographie ostéoarticulaire. Place actuelle. 2022 [cité 7 nov 2025]; Disponible sur: https://ajmhr.net/wp-content/uploads/2022/10/Echographie-osteoarticulaire.-Place-actuelle.pdf Lansier A, Brasseur JL. Intérêt de l’échographie pour l’étude du cartilage. J Traumatol Sport. 2018;35(2):108–14. Roberts HM, Moore JP, Thom JM. The Reliability of Suprapatellar Transverse Sonographic Assessment of Femoral Trochlear Cartilage Thickness in Healthy Adults. J Ultrasound Med avr. 2019;38(4):935–46. Naredo E, Acebes C, Möller I, Canillas F, de Agustín JJ, de Miguel E, et al. Ultrasound validity in the measurement of knee cartilage thickness. Ann Rheum Dis. 2009;68(8):1322–7. Möller I, Bong D, Naredo E, Filippucci E, Carrasco I, Moragues C, et al. Ultrasound in the study and monitoring of osteoarthritis. Osteoarthritis Cartilage. 2008;16:S4–7. Saito M, Ito H, Okahata A, Furu M, Nishitani K, Kuriyama S, et al. Ultrasonographic Changes of the Knee Joint Reflect Symptoms of Early Knee Osteoarthritis in General Population; The Nagahama Study. Cartil janv. 2022;13(1):19476035221077403. Özçakar L, Tunç H, Öken Ö, Ünlü Z, Durmuş B, Baysal Ö, et al. Femoral cartilage thickness measurements in healthy individuals: Learning, practicing and publishing with TURK-MUSCULUS. J Back Musculoskelet Rehabil 1 avr. 2014;27(2):117–24. Babayeva N, Dönmez G, Özçakar L, Torgutalp ŞŞ, Karaçoban L, Gedik E, et al. Mean femoral cartilage thickness is higher in athletes as compared with sedentary individuals. Knee Surg Sports Traumatol Arthrosc avr. 2021;29(4):1206–14. Bedewi MA, Elsifey AA, Naguib MF, Saleh AK, Nwihadh NB, Abd-Elghany AA, et al. Sonographic assessment of femoral cartilage thickness in healthy adults. J Int Med Res août. 2020;48(8):0300060520948754. Herrera HGA, Llinás PJ, Flórez L, Blanco Montes C, Vernaza Obando D, Díaz Solorzano A, et al. Ultrasound measurement of femoral cartilage thickness in the knee of healthy young university students. Rev Esp Cir Ortop Traumatol Engl Ed. 2020;64(4):244–50. Pane RV, Aisyah A, Ariani H, Isparnadi E, Hajiri AZZA, Setiawan A. Ultrasound assessment of femoral cartilage thickness among healthy Indonesian adults. Bali Med J. 2022;11(3):2013–6. Ariyachaikul S, Sriburee S, Thonglorm N, Kanthain R, Jankaew A. Comparison of knee articular cartilage thickness across sex and age groups in healthy adults. J Exp Orthop oct. 2025;12(4):e70490. Schneider D, Weber R, Nourkami-Tutdibi N, Bous M, Goedicke‐Fritz S, Hans MC, et al. Ultrasound‐guided determination demonstrates influence of age, sex and type of sport on medial femoral condyle cartilage thickness in children and adolescents. Knee Surg Sports Traumatol Arthrosc juin. 2024;32(6):1423–33. Gau CC, Yao TC, Gan ST, Lin SJ, Yeh KW, Chen LC, et al. Age, gender, height and weight in relation to joint cartilage thickness among school-aged children from ultrasonographic measurement. Pediatr Rheumatol déc. 2021;19(1):71. Spannow AH, Pfeiffer-Jensen M, Andersen NT, Herlin T, Stenbøg E. Ultrasonographic Measurements of Joint Cartilage Thickness in Healthy Children: Age- and Sex-Related Standard Reference Values. J Rheumatol 1 déc. 2010;37(12):2595–601. Oyamakinde SO, Ibitoye BO, Esan O, Famurewa OC, Aderibigbe AS. High-Resolution ultrasound of knee osteoarthritis in a Southwest Nigerian population: Our experience. J Musculoskelet Surg Res. 2019;3:209. Institut National de la Statistique et de la Démographie (INSD). Cinquième Recensement Général de la Population et de l'Habitation (RGPH): Rapport de présentation des résultats définitifs [Internet]. Ouagadougou: INSD; 2022. [cité 11 janv 2026]. Disponible sur. https://www.insd.bf/contenu/documents_rgph/Rapport_de_presentation_des_resultats_definitifs_RGPH_2019.pdf . Physical status. the use of and interpretation of anthropometry, report of a WHO expert committee [Internet]. [cité 26 déc 2025]. Disponible sur: https://www.who.int/publications/i/item/9241208546 Observatoire National de l'Activité Physique et de la Sédentarité (ONAPS). Guide d'utilisation du questionnaire IPAQ - version courte [Internet]. Clermont-Ferrand: ONAPS ; 2018 [cité 11 janv 2026]. Disponible sur : http://www.onaps.fr/ressources/outils-d-evaluation WMA - The World Medical Association. -Déclaration d’Helsinki de l’AMM – Principes éthiques applicables à la recherche médicale impliquant des participants humains [Internet]. [cité 26 déc 2025]. Disponible sur: https://www.wma.net/fr/policies-post/declaration-dhelsinki-de-lamm-principes-ethiques-applicables-a-la-recherche-medicale-impliquant-des-etres-humains/ Bedewi MA, Elsifey AA, Naguib MF, Saleh AK, Al-Ghamdi S, Alhariqi BA, et al. Ultrasonographic measurement of femoral cartilage thickness in type II diabetic patients. Med (Baltimore) avr. 2020;99(14):e19455. Sellam J, Courties A, Eymard F, Ferrero S, Latourte A, Ornetti P, et al. Recommandations de la Société française de rhumatologie sur la prise en charge pharmacologique de la gonarthrose. Rev Rhum déc. 2020;87(6):439–46. Jones G, Glisson M, Hynes K, Cicuttini F. Sex and site differences in cartilage development: A possible explanation for variations in knee osteoarthritis in later life. Arthritis Rheum. 2000;43(11):2543–9. Collins AT, Kulvaranon ML, Cutcliffe HC, Utturkar GM, Smith WAR, Spritzer CE, et al. Obesity alters the in vivo mechanical response and biochemical properties of cartilage as measured by MRI. Arthritis Res Ther. oct 2018;17(1):232. Mezhov V, Ciccutini FM, Hanna FS, Brennan SL, Wang YY, Urquhart DM, et al. Does obesity affect knee cartilage? A systematic review of magnetic resonance imaging data. Obes Rev févr. 2014;15(2):143–57. CAPTIONS FOR. FIGURES AND TABLES. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 27 Apr, 2026 Reviews received at journal 23 Apr, 2026 Reviewers agreed at journal 20 Apr, 2026 Reviews received at journal 16 Mar, 2026 Reviews received at journal 07 Mar, 2026 Reviewers agreed at journal 05 Mar, 2026 Reviewers agreed at journal 04 Mar, 2026 Reviewers invited by journal 24 Feb, 2026 Editor invited by journal 03 Feb, 2026 Editor assigned by journal 03 Feb, 2026 Submission checks completed at journal 03 Feb, 2026 First submitted to journal 31 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8747970","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":596959771,"identity":"79b3aa43-e5fa-44e8-9579-978818462420","order_by":0,"name":"Aboubakar Ouédraogo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0klEQVRIiWNgGAWjYBACAwYGNgbGBgYGfgkwX0KGWC0GDJIzwDoleIjXYnADrIWBsBZz9h6zBz93/JE3vt18/NGNGgseBvbDRzfg02LZc8bcsPeMgeG2O8cSm3OOAR3Gk5Z2A6/DbuSYSfC2GSSY3cgxbM5hA2qR4DEjqEXyL1CL8QyQln9EapEG2WIgAdSS20aEFsueY+XGsm3GhjNupCXOzu2T4GEj5Bdz9uZtD9+2ycnzz0g+8DnnW50cP/vhY3i1YAI20pSPglEwCkbBKMAGALeKRZa6/ZXIAAAAAElFTkSuQmCC","orcid":"","institution":"Rheumatology Department, Bogodogo University Hospital Center","correspondingAuthor":true,"prefix":"","firstName":"Aboubakar","middleName":"","lastName":"Ouédraogo","suffix":""},{"id":596959772,"identity":"32df6cf7-bcf4-48be-8efc-a8ca0ea89e08","order_by":1,"name":"Safiatou Nikiéma/Ouédraogo","email":"","orcid":"","institution":"Rheumatology Department, Bogodogo University Hospital Center","correspondingAuthor":false,"prefix":"","firstName":"Safiatou","middleName":"","lastName":"Nikiéma/Ouédraogo","suffix":""},{"id":596959773,"identity":"dea5ac25-9378-424e-8530-6f26e744661a","order_by":2,"name":"Yamyellé E. Zongo","email":"","orcid":"","institution":"Rheumatology Department, Bogodogo University Hospital Center","correspondingAuthor":false,"prefix":"","firstName":"Yamyellé","middleName":"E.","lastName":"Zongo","suffix":""},{"id":596959774,"identity":"b91a6532-dfde-4fb1-b0d9-510e84ac442b","order_by":3,"name":"Aminata S. H. Iname/Konaté","email":"","orcid":"","institution":"Medical Imaging and Interventional Radiology Department, Bogodogo University Hospital Center","correspondingAuthor":false,"prefix":"","firstName":"Aminata","middleName":"S. H.","lastName":"Iname/Konaté","suffix":""},{"id":596959775,"identity":"c0ca39c0-40bc-4e25-a0f0-61973b85b7bc","order_by":4,"name":"Charles Sougue","email":"","orcid":"","institution":"Higher Institute of Health Sciences (INSSA)/Nazi Boni University (UNB)/ Internal Medicine Department, Sourô Sanou University Hospital (CHUSS), Bobo-Dioulasso","correspondingAuthor":false,"prefix":"","firstName":"Charles","middleName":"","lastName":"Sougue","suffix":""},{"id":596959776,"identity":"11544199-a528-4c22-993b-6daa65879e53","order_by":5,"name":"Jacqueline Coulibaly/Koudougou","email":"","orcid":"","institution":"Medical Imaging and Interventional Radiology Department, Bogodogo University Hospital Center","correspondingAuthor":false,"prefix":"","firstName":"Jacqueline","middleName":"","lastName":"Coulibaly/Koudougou","suffix":""},{"id":596959777,"identity":"9c5c3aae-4730-4e66-b8da-d6bc72d5b337","order_by":6,"name":"Benilde M. A. Kambou/Tiemtoré","email":"","orcid":"","institution":"Medical Imaging and Interventional Radiology Department, Bogodogo University Hospital Center","correspondingAuthor":false,"prefix":"","firstName":"Benilde","middleName":"M. A.","lastName":"Kambou/Tiemtoré","suffix":""},{"id":596959778,"identity":"d8fb9004-833d-4899-83b2-dff96f7413c0","order_by":7,"name":"Joelle W. S. Tiendrebeogo/Zabsonré","email":"","orcid":"","institution":"Rheumatology Department, Bogodogo University Hospital Center","correspondingAuthor":false,"prefix":"","firstName":"Joelle","middleName":"W. S.","lastName":"Tiendrebeogo/Zabsonré","suffix":""},{"id":596959779,"identity":"b36b20c8-7306-47ac-a443-621c77f7c6e8","order_by":8,"name":"Dieu-Donné Ouédraogo","email":"","orcid":"","institution":"Rheumatology Department, Bogodogo University Hospital Center","correspondingAuthor":false,"prefix":"","firstName":"Dieu-Donné","middleName":"","lastName":"Ouédraogo","suffix":""}],"badges":[],"createdAt":"2026-01-31 08:24:45","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8747970/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8747970/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":103731872,"identity":"1dfed9eb-e722-437f-b722-98aeafc95b5e","added_by":"auto","created_at":"2026-03-02 09:18:26","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":457744,"visible":true,"origin":"","legend":"\u003cp\u003eKnee position and measurement site of trochlear articular cartilage\u003c/p\u003e\n\u003cp\u003eMC medial condyle; LC lateral condyle; ZIC intercondylar zone\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8747970/v1/25bab44949dfe598d879f6d3.png"},{"id":104399970,"identity":"b9c7d764-7acb-417a-a397-8b5e4a69f318","added_by":"auto","created_at":"2026-03-11 12:08:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1728444,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8747970/v1/183496f5-ec93-4db5-893e-43074546b458.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Ultrasound reference values for trochlear cartilage in healthy black African subjects: a study of a cohort of 506 participants","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eArticular cartilage is a highly specialized connective tissue covering the articular bone surfaces, allowing them to slide thanks to its low friction coefficient and its mechanical properties, elasticity, lubrication, and resistance to compressive forces. Its study is of major interest for the early diagnosis and treatment of osteoarthritis [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOsteoarticular and muscular disorders affect more than 1.7\u0026nbsp;billion people worldwide and are the leading cause of disability according to the World Health Organization (WHO) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. With a frequency of 365\u0026nbsp;million people affected, the knee is the joint most commonly affected by osteoarthritis, followed by the hand and hip [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe development of drugs capable of modifying the natural progression of osteoarthritis is a major research goal for scientists; imaging plays an important role in evaluating these treatments on cartilage [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Standard radiography provides an indirect assessment of articular cartilage but remains a source of radiation exposure [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Arthroscopic scanning allows direct, volumetric visualization of cartilage with good spatial resolution but is invasive [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Magnetic resonance imaging (MRI), considered the gold standard for assessing cartilage thickness, is expensive and has limited accessibility and availability [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Ultrasound is a non-invasive, accessible imaging modality for assessing articular cartilage [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. It is a reliable and validated imaging technique for measuring femoral trochlear cartilage [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The ability to mobilize the knee and contract the quadriceps femoris muscle makes this joint an ideal site for measuring articular cartilage [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The articular cartilage of the femoral trochlea is visible, accessible without complex preparation, and allows for rapid and reproducible bilateral assessment in routine clinical practice [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Knowledge of normal articular cartilage thickness values allows for early detection of osteoarthritic lesions [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eData from the literature on the average thickness of femoral trochlear cartilage show significant variations depending on geographical context. In Turkey, the study by \u0026Ouml;z\u0026ccedil;akar et al. established averages between 2 and 2.3 mm [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], results similar to those obtained by Babayeva et al. (2.1 to 2.2 mm) [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], Bedewi et al. in Saudi Arabia (1.95 to 2.17 mm) [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] and Herrera et al. in Colombia (1.9 to 2.3 mm) [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Conversely, lower measurements were documented in Indonesia by Pane et al., with averages ranging from 1.69 mm to 1.92 mm depending on the compartment [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBeyond these averages, several factors significantly influence the variability of this thickness. Gender and physical activity appear to be the most frequently reported determinants. Thicker cartilage is regularly observed in men and high-level athletes in several studies [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Other variables are also reported more heterogeneously, such as age, height, and smoking [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]; however, body mass index (BMI) does not appear to be systematically correlated with these variations [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAll of these studies, conducted in Caucasian populations, have established reference values for the articular cartilage of the femoral trochlea and objectively demonstrated multifactorial variability in the thickness of this cartilage, particularly in relation to gender, age, various anthropometric parameters, and physical activity [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR15\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe scarcity of ultrasound studies on articular cartilage in black African populations contrasts with the preponderance of data from Caucasian populations and highlights the relevance of establishing reference values specific to this population [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe absence of established standards for this population raises a fundamental question: what are the normal values for femoral trochlear articular cartilage thickness, as measured by ultrasound, in healthy black African subjects? What factors may be associated with variation in the thickness of this cartilage? The main objective of our study was to establish reference values (normal values) for the thickness of the femoral trochlear cartilage, measured by ultrasound in healthy adults of black African origin.\u003c/p\u003e "},{"header":"METHODS","content":"\n\u003ch3\u003e1. Type and period of study\u003c/h3\u003e\n\u003cp\u003eThis is a descriptive and analytical cross-sectional study conducted over a 6-month period from April 1 to September 15, 2025. The aim was to determine the ultrasound reference values for femoral trochlear cartilage thickness in healthy adults of African descent, while identifying the factors influencing its morphological changes.\u003c/p\u003e\n\u003ch3\u003e2. Study setting\u003c/h3\u003e\n\u003cp\u003eThe Rheumatology and Medical Imaging departments of the Bogodogo University Hospital Center (CHU-B) in Ouagadougou (Burkina Faso) served as the setting for the study. Burkina Faso is a country of 272,200 km\u0026sup2; located in West Africa with an estimated population of 20,487,979 inhabitants [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003e3. Study population\u003c/h3\u003e\n\u003cp\u003eThe study population consisted of all healthy black African adults residing in Ouagadougou during the study period and meeting the inclusion criteria.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Sampling\u003c/h2\u003e \u003cp\u003e Participants were recruited on a convenience basis from among CHU-B staff, students interning at the hospital, police cadets receiving medical training as part of their medical visits, and CHU-B users.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Inclusion criteria\u003c/h2\u003e \u003cp\u003eParticipants aged 18 to 45 years of age with no history of disease or current symptoms in the knees or pelvic limbs, who were admitted to the CHU-B during the study period and who gave their informed consent were included in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.3. Exclusion criteria\u003c/h2\u003e \u003cp\u003eParticipants being treated for knee joint cartilage disease (inflammatory or degenerative), autoimmune disease, or rheumatic diseases were not included in the study. The same applied to participants with a history of surgery or trauma to the knee or pelvic limb, a static disorder of the pelvic limbs, or who had already undergone knee infiltration.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e4. Study procedure\u003c/h3\u003e\n\u003cp\u003eAfter obtaining informed consent from participants and conducting a complete clinical examination, a suprapatellar cross-section of both knees was performed on a patient lying supine on an examination table with the knee flexed to the maximum (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e1\u003c/span\u003e). A SIEMENS ACUSON NX3 Elite ultrasound machine with a high-frequency linear probe (8 to 15 MHz) was used. The ultrasound was performed by the same radiologist for all participants. The trochlear cartilage was measured on both femoral condyles and the intercondylar area (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003e5. Study variables\u003c/h3\u003e\n\u003cp\u003eSocio-demographic data (age, gender), anthropometric data (height, weight, body mass index), and lifestyle (physical activity) were the independent variables in our study. BMI (in kg/m\u0026sup2;) was interpreted according to WHO classifications [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The level of physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) score (short version) [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUltrasound data (measurement of the thickness of the articular cartilage of the medial and lateral condyles and the intercondylar area of the knees) constituted the dependent variables.\u003c/p\u003e\n\u003ch3\u003e6. Data collection and analysis\u003c/h3\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e6.1. Data collection\u003c/h2\u003e \u003cp\u003eData were collected using a standardized survey form administered directly to participants. This tool was used to collect the sociodemographic, anthropometric, and ultrasound information needed for the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e6.2. Statistical analysis\u003c/h2\u003e \u003cp\u003eData processing and analysis were performed using STATA software (version 14.0). Quantitative variables are expressed as means accompanied by their standard deviations and extreme values (min\u0026ndash;max). Qualitative variables are presented as numbers and percentages.\u003c/p\u003e \u003cp\u003eCorrelations between measurements of the femoral trochlear cartilage (at the medial condyle (MC), lateral condyle (LC), and intercondylar zone (ICZ)) and socio-demographic and anthropometric variables and level of physical activity were analyzed using Pearson's or Spearman's correlation test depending on the distribution of the variables for quantitative variables and Student's t-test for qualitative variables. For all analyses, the statistical significance threshold was set at p\u0026thinsp;\u0026le;\u0026thinsp;0.05.\u003c/p\u003e \u003cp\u003eIn order to identify the factors associated with the thickness of the femoral trochlear articular cartilage, a multiple linear regression (calculation of the beta coefficient with the p-value) was performed between the dependent variable and the independent variables. Adjustments and modeling were then performed with those that had a p\u0026thinsp;\u0026le;\u0026thinsp;0.05. This allowed us to obtain the association coefficient β, which varies between \u0026minus;\u0026thinsp;1 (negative association) and +\u0026thinsp;1 (positive association), passing through 0 (no association). The closer the absolute value of the coefficient β is to 1, the stronger the association. The variables with a p\u0026thinsp;\u0026le;\u0026thinsp;0.05 were retained as factors associated with the thickness of the femoral trochlear articular cartilage.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e7. Ethical considerations\u003c/h3\u003e\n\u003cp\u003eThe protocol was validated by the CHU-B institutional ethics committee by deliberation No. 2025-01-03 of March 25, 2025. The confidentiality and anonymity of participants were respected throughout our study. Written informed consent was obtained from each volunteer invited to participate in the study prior to enrollment. The study was conducted in accordance with the Declaration of Helsinki [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003e8. Declaration of generative ai and ai-assisted technologies in the writing process\u003c/h3\u003e\n\u003cp\u003eGenerative AI was used to improve the clarity of several sentences in this manuscript. During the preparation of this work the author used Gemini in order to check clarity and readability of several sentences. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003ch3\u003e1. Population characteristics\u003c/h3\u003e\n\u003cp\u003eFive hundred and six participants took part in the study. Ultrasound measurements of trochlear cartilage were performed on 1,012 knees. The participants included 408 men (80.63%) and 98 women (19.37%), with a sex ratio of 4.16. The mean age was 24.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.42 years, with extremes of 19 and 45 years. Table\u0026nbsp;1 shows the general characteristics of the study population.\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 1\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eGeneral characteristics of the study population and ultrasound measurement of articular cartilage\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;Standard deviation\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eExtremes\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;506)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eHeight (cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e174,95\u0026thinsp;\u0026plusmn;\u0026thinsp;5,42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[154\u0026ndash;196]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eWeight (kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e70,28\u0026thinsp;\u0026plusmn;\u0026thinsp;8,47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[44,65\u0026ndash;126,3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eBMI (kg/m\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22,94\u0026thinsp;\u0026plusmn;\u0026thinsp;2,64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[16\u0026ndash;42,69]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eUnderweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2,17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eNormal weight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e420\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83,00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12,65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eModerate obesity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1,58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eSevere obesity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eMorbid obesity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eLevel of physical activity (IPAQ score)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eHigh level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e397\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78,46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eModerate level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13,44\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eLow level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8,1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eCartilage thickness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eRight knee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2,34\u0026thinsp;\u0026plusmn;\u0026thinsp;0,46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[1, 1\u0026ndash;3, 8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eZIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2,61\u0026thinsp;\u0026plusmn;\u0026thinsp;0,61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[1, 2\u0026ndash;5, 6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2,42\u0026thinsp;\u0026plusmn;\u0026thinsp;0, 47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[1,2 6\u0026thinsp;\u0026minus;\u0026thinsp;4,40]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eLeft knee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2,37\u0026thinsp;\u0026plusmn;\u0026thinsp;0,50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[1, 2\u0026ndash;4, 20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eZIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2,60\u0026thinsp;\u0026plusmn;\u0026thinsp;0,62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[1,00\u0026ndash;5,30]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2,34\u0026thinsp;\u0026plusmn;\u0026thinsp;0,47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[1,01\u0026ndash;4,01]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003ch3\u003e2. Ultrasound measurements of cartilage\u003c/h3\u003e\n\u003cp\u003eThe mean thickness of the femoral trochlear articular cartilage measured at the medial condyle (MC) of the knees was 2.36 mm, with extremes of 2.36 mm and 8 mm. The mean thickness of the lateral condyle (LC) was 2.38 mm, with extremes of 2.21 mm and 8.41 mm. The average thickness of trochlear cartilage measured at the intercondylar zone (ICZ) was 2.60 mm, with extremes of 2.20 mm and 10.9 mm. Table\u0026nbsp;1 summarizes the average thickness of trochlear cartilage measured according to knee and anatomical zone.\u003c/p\u003e\n\u003ch3\u003e3. Analytical study\u003c/h3\u003e\n\u003cdiv id=\"Sec19\"\u003e\n \u003ch2\u003e3.1. Bivariate analysis\u003c/h2\u003e\n \u003cp\u003eThe analysis showed that the average cartilage thickness was significantly higher in men than in women at all measurement sites (p\u0026thinsp;=\u0026thinsp;0.001). In the right knee, measurements in men were 2.39\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46 mm (MC), 2.49\u0026thinsp;\u0026plusmn;\u0026thinsp;0.47 mm (LC), and 2.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60 mm (ZIC), compared to 2.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4 mm, 2.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37 mm, and 2.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49 mm in women, respectively. The averages observed in the left knee were 2.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50 mm (CM), 2.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46 mm (CL) and 2.70\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61 mm (ZIC), while in women they were 2.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.41 mm (CM), 2.05\u0026thinsp;\u0026plusmn;\u0026thinsp;0.39 mm (CL) and 2.17\u0026thinsp;\u0026plusmn;\u0026thinsp;0.45 mm (ZIC). All of these bivariate analyses are summarized in Table\u0026nbsp;2.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Summary of bivariate analyses\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical activity (IPAQ score)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCartilage thickness (mm)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eAge (years)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003eWeight (kg)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003eBMI (kg/m\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eLow level \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eModerate level \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eHigh level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eCorrelation (r)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eCorrelation (r)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eCorrelation (r)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAverage\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAverage\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAverage\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eRight knee\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCM\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e- 0,100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,144 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,001 \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0,194\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,1975\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eZIC\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e-0,141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,213 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0,001 \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0,006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,\u0026nbsp;39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,0030\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCL\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e-0,097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,226 \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0,001 \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,177\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;0,001 \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,\u0026nbsp;32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,1781\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLeft knee\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCM\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e-0,064\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,190\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0,001 \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0,012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,2116\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eZIC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e-0,092\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,220 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0,001 \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0,002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCL\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e-0,037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,186 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0,001 \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0,116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0,009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2,35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0,3099\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003eBMI: body mass index, MC medial condyle; LC lateral condyle; ZIC intercondylar zone\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec20\"\u003e\n \u003ch2\u003e3.2. Multivariate analysis\u003c/h2\u003e\n \u003cp\u003eMultiple linear regression was performed to assess the association between femoral trochlear articular cartilage thickness and the various independent variables.\u003c/p\u003e\n \u003cp\u003eIn the initial model, the \u0026beta; coefficient associating gender with cartilage thickness varied between 0.196 and 0.481 depending on the compartments measured, with constant statistical significance (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). After adjustment and final modeling, the \u0026beta; coefficient for gender then varied between 0.207 and 0.532 for all compartments (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). There is an association between gender and cartilage thickness, independent of the other variables included in the model. Table\u0026nbsp;3 presents a detailed summary of these multivariate analyses.\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 3\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eDetailed summary of these multivariate analyses.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"12\"\u003e\n \u003cp\u003eCartilage thickness *\u003c/p\u003e\n \u003cp\u003e\u0026beta; coefficient\u003c/p\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eCMD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eZICD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eCLD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eCMG\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eZICG\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eCLG\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eInitial model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFinal model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eInitial model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFinal model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eInitial model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFinal model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eInitial model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFinal model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eInitial model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFinal model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eInitial model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFinal model\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,009\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,145\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,020\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,014\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,018\u003c/p\u003e\n \u003cp\u003e0,165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,011\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,071\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,002\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,676\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,008\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,299\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,012\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,849\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,196\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,002\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,207\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,407\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,471\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,313\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0,342\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,262\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,274\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,481\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0,532\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,377\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,357\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,052\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,009\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,053\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,008\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,021\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,418\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,001\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,950\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,0777\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,079\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,038\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,134\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,052\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,009\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,050\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,011\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,142\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,019\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;0,147\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,014\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0, 027\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,725\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0,038\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,530\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,205\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,002\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,213\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,001\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,082\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,291\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,139\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,021\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0,131\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e0,028\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\"\u003eBMI: body mass index, MC medial condyle; LC lateral condyle; ZIC intercondylar zone\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eOur study, conducted on a sample of 1,012 knees, establishes the first normative values for femoral trochlear cartilage thickness by ultrasound in young, healthy subjects in sub-Saharan Africa. Our results reveal a variation in cartilage thickness depending on the anatomical area explored, with respective averages of 2.36 mm at the medial condyle, 2.38 mm at the lateral condyle, and a maximum thickness of 2.60 mm at the intercondylar area. These results could provide a necessary reference for clinical practice for accurate and optimal interpretation of ultrasound measurements of articular cartilage in this specific population. Furthermore, our analysis highlights that factor such as gender, weight and, to a lesser extent, age and level of physical activity influence cartilage morphology, both globally and compartmentally.\u003c/p\u003e \u003cp\u003eThe study of normal cartilage suggests the selection of a young population. In our study, the average age of the population was 24.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.42 years. This finding has been observed in several studies of articular cartilage in healthy populations. Indeed, Herrera et al. in Colombia, Bedewi et al. in Saudi Arabia, \u0026Ouml;z\u0026ccedil;akar et al. in Turkey, and Pane et al. in Indonesia found average ages of 20\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5 years, 30.60 years\u0026thinsp;\u0026plusmn;\u0026thinsp;6.13 years, 31.7 years\u0026thinsp;\u0026plusmn;\u0026thinsp;4.8 years, and 32.83 years\u0026thinsp;\u0026plusmn;\u0026thinsp;13.67 years [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. However, Roberts et al. in the United Kingdom reported an average age of 43 years\u0026thinsp;\u0026plusmn;\u0026thinsp;18 years, which is higher than ours [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Selecting a young population is the best way to avoid the presence of degenerative lesions that appear after the age of 40 and can impact the measurement of cartilage thickness [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe average thickness of trochlear cartilage observed in our study, all compartments combined, was comparable to the values reported by \u0026Ouml;z\u0026ccedil;akar et al. in Turkey [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. However, our measurements are higher than those documented by Roberts et al. in the United Kingdom, Bedewi et al. in Saudi Arabia, and Pane et al. in Indonesia (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e) [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. This disparity could be attributed to the relative youth of our sample, as well as the fact that the vast majority of our participants were involved in intensive sports activities. The influence of ethnic origin could also be cited as a contributing factor, although this hypothesis needs to be confirmed by a subsequent comparative study between Caucasian and Black African populations.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparative table of ultrasound reference values for trochlear cartilage in healthy subjects\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eStudies\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eAverage cartilage thickness according to compartment measured in mm\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eStudy population size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSex ratio\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eRight knee\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003e\u003cb\u003eLeft knee\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eMC\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eZIC\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eLC\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eMC\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eZIC\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eLC\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOur study Burkina Faso 2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2,34\u0026thinsp;\u0026plusmn;\u0026thinsp;0,46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2,61\u0026thinsp;\u0026plusmn;\u0026thinsp;0,61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e2,42\u0026thinsp;\u0026plusmn;\u0026thinsp;0,47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2,37\u0026thinsp;\u0026plusmn;\u0026thinsp;0,50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e2,60\u0026thinsp;\u0026plusmn;\u0026thinsp;0,62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e2,34\u0026thinsp;\u0026plusmn;\u0026thinsp;0,47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e506\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4,16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePane et al. 2022\u003c/p\u003e \u003cp\u003e(Indon\u0026eacute;sie)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1,76\u0026thinsp;\u0026plusmn;\u0026thinsp;0,33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1,92\u0026thinsp;\u0026plusmn;\u0026thinsp;0,39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e1,71\u0026thinsp;\u0026plusmn;\u0026thinsp;0,31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1,76\u0026thinsp;\u0026plusmn;\u0026thinsp;0,34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e1,9\u0026thinsp;\u0026plusmn;\u0026thinsp;0,33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1,89\u0026thinsp;\u0026plusmn;\u0026thinsp;0,34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0,44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBedewi et al. 2020 (Saudi Arabia)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2,0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2,1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e2,0\u0026thinsp;\u0026plusmn;\u0026thinsp;0,03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1,9\u0026thinsp;\u0026plusmn;\u0026thinsp;0,04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e2,1\u0026thinsp;\u0026plusmn;\u0026thinsp;0,05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e2,3\u0026thinsp;\u0026plusmn;\u0026thinsp;0,03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRoberts et al. 2019 (United Kingdom)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1,86\u0026thinsp;\u0026plusmn;\u0026thinsp;0,30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2,07\u0026thinsp;\u0026plusmn;\u0026thinsp;0,43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e1,87\u0026thinsp;\u0026plusmn;\u0026thinsp;0,30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1,78\u0026thinsp;\u0026plusmn;\u0026thinsp;0,34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e2,08\u0026thinsp;\u0026plusmn;\u0026thinsp;0,41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1,76\u0026thinsp;\u0026plusmn;\u0026thinsp;0,32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e2,50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026Ouml;z\u0026ccedil;akar et al. 2014 (Turkey)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2,20\u0026thinsp;\u0026plusmn;\u0026thinsp;0,50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2,30\u0026thinsp;\u0026plusmn;\u0026thinsp;0,60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e2,20\u0026thinsp;\u0026plusmn;\u0026thinsp;0,50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2,20\u0026thinsp;\u0026plusmn;\u0026thinsp;0,50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e2,30\u0026thinsp;\u0026plusmn;\u0026thinsp;0,60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e2,20\u0026thinsp;\u0026plusmn;\u0026thinsp;0,50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1438\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1,31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003eMC medial condyle; LC lateral condyle; ZIC intercondylar zone\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn our study, bivariate analysis initially revealed a positive correlation between gender, anthropometric variables (weight, BMI), and trochlear articular cartilage thickness, while a negative correlation was observed with age. However, after adjustment by multiple linear regression, only gender and weight maintained an independent positive association with cartilage thickness. Conversely, BMI showed a negative association.\u003c/p\u003e \u003cp\u003eThe absence of a significant association between age and cartilage thickness in multivariate analysis is consistent with the work of Bedewi et al. and Pane et al. [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Although the literature typically reports a decrease in cartilage thickness with aging, age is a non-modifiable risk factor for osteoarthritis [\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Our results could be explained by the relative youth and homogeneity of our sample. The age range was probably not sufficient to detect the structural effects of aging, which generally become apparent after the age of 40 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Gender is the most consistently found factor influencing the variability of femoral trochlear cartilage thickness. In line with almost all of the literature, we observed greater thickness in male subjects [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. While the role of sex hormones is often mentioned, the exact pathophysiological mechanisms remain to be elucidated [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. It should be noted that this gender disparity is also described in prepubescent children by Gau et al. and Spannow et al., suggesting that, in addition to biological factors, physical activity and environmental factors play a crucial role in cartilage development from an early age [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe link between weight and cartilage thickness is controversial in the literature: while Babayeva et al. and Roberts et al. confirm this correlation [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], this finding has not been made by \u0026Ouml;z\u0026ccedil;akar et al., Bedewi et al., or Pane et al. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. From a biomechanical perspective, excess weight increases joint stress, ultimately promoting harmful remodeling and thinning of the cartilage [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. This observation is consistent with the negative association between high BMI and cartilage thickness found in our study and is in line with the work of Roberts et al., Amber et al., and Collins et al., who highlight the harmful influence of obesity on knee cartilage [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. However, the overall preservation (or even increase) in cartilage thickness in our population could be explained by the specific profile of the participants: 83% had a normal BMI and 91.9% engaged in regular physical activity. This active lifestyle promotes protective muscle mass and optimal weight modulation.\u003c/p\u003e \u003cp\u003eOur study had limitations that should be taken into account when interpreting our results. The classic limitations of data interpretation in cross-sectional studies may apply to our study. A potential selection bias should be considered due to the convenience sampling (non-probabilistic) recruitment method. This approach could limit the representativeness of the sample in relation to the general population and, consequently, restrict the generalizability of our conclusions. In addition, the ultrasound was performed by a single sonographer, which may have introduced measurement bias. Nevertheless, our examination protocol was rigorously standardized to minimize this impact.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis study proposes the first normative ultrasound values for femoral trochlear cartilage in a population of young, healthy subjects in sub-Saharan Africa. By precisely quantifying cartilage thickness and identifying factors that influence variation, such as weight, gender, and BMI, this work provides an essential reference for regional clinical and radiological practice. However, these results are a first step that calls for further investigation. Validation of these measurements by reference imaging techniques, such as MRI, will be a crucial step in consolidating the reliability of the ultrasound tool. Finally, the deployment of longitudinal studies would allow for better characterize the dynamics of cartilage evolution and identify early markers of degeneration.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eETHICS APPROVAL AND CONSENT TO PARTICIPATE\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe protocol was validated by the CHU-B institutional ethics committee by deliberation No. 2025-01-03 of March 25, 2025. The confidentiality and anonymity of participants were respected throughout our study. Written informed consent was obtained from each volunteer invited to participate in the study prior to enrollment. The study was conducted in accordance with the Declaration of Helsinki [25].\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eCONSENT FOR PUBLICATION\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eAVAILABILITY OF DATA AND MATERIALS\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eData supporting the results of this study are available from the corresponding author on reasonable request\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eCOMPETING INTERESTS\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eFUNDING\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThis work did not receive any funding of any kind.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eAUTHORS' CONTRIBUTIONS\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eA.O\u003c/strong\u003e: Contributing to the conceptualization, the data curation, the methodology, the formal analysis, the supervision, the validation and the writing of the original draft.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eS.N/O\u003c/strong\u003e : Contributing to the conceptualization, the data curation and the methodology.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eY.E.Z:\u003c/strong\u003e Contributing to the conceptualization, the data curation the methodology, the supervision, the validation and the writing of the original draft.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA.S.I/K\u003c/strong\u003e: Contributing to the conceptualization, the methodology, the validation and the writing of the original draft.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eC.S\u003c/strong\u003e: Contributing to the validation and the writing of the original draft.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eJ.C/K\u003c/strong\u003e: Contributing to the supervision, the validation and writing – review and editing.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eB.M.K/T\u003c/strong\u003e: Contributing to the supervision, the validation and the writing of the original draft.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eJ.W.S.T/Z\u003c/strong\u003e: Contributing to the visualization, the validation and the writing of the original draft.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eD-D.O:\u003c/strong\u003e Contributing to the validation and the writing of the original draft.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eACKNOWLEDGEMENTS\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eAUTHORS' INFORMATION (OPTIONAL)\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eChevalier X, Richette P. Cartilage articulaire normal: anatomie, physiologie, m\u0026eacute;tabolisme, vieillissement. EMC - Rhumatol-Orthop\u0026eacute;die. janv. 2005;2(1):41\u0026ndash;58.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrganisation mondiale de la Sant\u0026eacute;. Affections ost\u0026eacute;o-articulaires et musculaires [Internet]. Gen\u0026egrave;ve: Organisation mondiale de la Sant\u0026eacute; ; 14 juill 2022 [cit\u0026eacute; 26 d\u0026eacute;c 2025]. Disponible sur : \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/fr/news-room/fact-sheets/detail/musculoskeletal-conditions\u003c/span\u003e\u003cspan address=\"https://www.who.int/fr/news-room/fact-sheets/detail/musculoskeletal-conditions\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrganisation mondiale de la Sant\u0026eacute;. Arthrose [Internet]. Gen\u0026egrave;ve: Organisation mondiale de la Sant\u0026eacute; ; 14 juill 2023 [cit\u0026eacute; 26 d\u0026eacute;c 2025]. Disponible sur : \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/fr/news-room/fact-sheets/detail/osteoarthritis\u003c/span\u003e\u003cspan address=\"https://www.who.int/fr/news-room/fact-sheets/detail/osteoarthritis\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSteinmetz JD, Culbreth GT, Haile LM, Rafferty Q, Lo J, Fukutaki KG, et al. Global, regional, and national burden of osteoarthritis, 1990\u0026ndash;2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol sept. 2023;5(9):e508\u0026ndash;22.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLaredo JD. [New developments in cartilage imaging]. Bull Acad Natl Med oct. 2006;190(7):1459\u0026ndash;73. discussion 1473\u0026ndash;1477.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSlimani S. Echographie ost\u0026eacute;oarticulaire. Place actuelle. 2022 [cit\u0026eacute; 7 nov 2025]; Disponible sur: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://ajmhr.net/wp-content/uploads/2022/10/Echographie-osteoarticulaire.-Place-actuelle.pdf\u003c/span\u003e\u003cspan address=\"https://ajmhr.net/wp-content/uploads/2022/10/Echographie-osteoarticulaire.-Place-actuelle.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLansier A, Brasseur JL. Int\u0026eacute;r\u0026ecirc;t de l\u0026rsquo;\u0026eacute;chographie pour l\u0026rsquo;\u0026eacute;tude du cartilage. J Traumatol Sport. 2018;35(2):108\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRoberts HM, Moore JP, Thom JM. The Reliability of Suprapatellar Transverse Sonographic Assessment of Femoral Trochlear Cartilage Thickness in Healthy Adults. J Ultrasound Med avr. 2019;38(4):935\u0026ndash;46.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNaredo E, Acebes C, M\u0026ouml;ller I, Canillas F, de Agust\u0026iacute;n JJ, de Miguel E, et al. Ultrasound validity in the measurement of knee cartilage thickness. Ann Rheum Dis. 2009;68(8):1322\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eM\u0026ouml;ller I, Bong D, Naredo E, Filippucci E, Carrasco I, Moragues C, et al. Ultrasound in the study and monitoring of osteoarthritis. Osteoarthritis Cartilage. 2008;16:S4\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaito M, Ito H, Okahata A, Furu M, Nishitani K, Kuriyama S, et al. Ultrasonographic Changes of the Knee Joint Reflect Symptoms of Early Knee Osteoarthritis in General Population; The Nagahama Study. Cartil janv. 2022;13(1):19476035221077403.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u0026Ouml;z\u0026ccedil;akar L, Tun\u0026ccedil; H, \u0026Ouml;ken \u0026Ouml;, \u0026Uuml;nl\u0026uuml; Z, Durmuş B, Baysal \u0026Ouml;, et al. Femoral cartilage thickness measurements in healthy individuals: Learning, practicing and publishing with TURK-MUSCULUS. J Back Musculoskelet Rehabil 1 avr. 2014;27(2):117\u0026ndash;24.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBabayeva N, D\u0026ouml;nmez G, \u0026Ouml;z\u0026ccedil;akar L, Torgutalp ŞŞ, Kara\u0026ccedil;oban L, Gedik E, et al. Mean femoral cartilage thickness is higher in athletes as compared with sedentary individuals. Knee Surg Sports Traumatol Arthrosc avr. 2021;29(4):1206\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBedewi MA, Elsifey AA, Naguib MF, Saleh AK, Nwihadh NB, Abd-Elghany AA, et al. Sonographic assessment of femoral cartilage thickness in healthy adults. J Int Med Res ao\u0026ucirc;t. 2020;48(8):0300060520948754.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHerrera HGA, Llin\u0026aacute;s PJ, Fl\u0026oacute;rez L, Blanco Montes C, Vernaza Obando D, D\u0026iacute;az Solorzano A, et al. Ultrasound measurement of femoral cartilage thickness in the knee of healthy young university students. Rev Esp Cir Ortop Traumatol Engl Ed. 2020;64(4):244\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePane RV, Aisyah A, Ariani H, Isparnadi E, Hajiri AZZA, Setiawan A. Ultrasound assessment of femoral cartilage thickness among healthy Indonesian adults. Bali Med J. 2022;11(3):2013\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAriyachaikul S, Sriburee S, Thonglorm N, Kanthain R, Jankaew A. Comparison of knee articular cartilage thickness across sex and age groups in healthy adults. J Exp Orthop oct. 2025;12(4):e70490.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchneider D, Weber R, Nourkami-Tutdibi N, Bous M, Goedicke‐Fritz S, Hans MC, et al. Ultrasound‐guided determination demonstrates influence of age, sex and type of sport on medial femoral condyle cartilage thickness in children and adolescents. Knee Surg Sports Traumatol Arthrosc juin. 2024;32(6):1423\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGau CC, Yao TC, Gan ST, Lin SJ, Yeh KW, Chen LC, et al. Age, gender, height and weight in relation to joint cartilage thickness among school-aged children from ultrasonographic measurement. Pediatr Rheumatol d\u0026eacute;c. 2021;19(1):71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSpannow AH, Pfeiffer-Jensen M, Andersen NT, Herlin T, Stenb\u0026oslash;g E. Ultrasonographic Measurements of Joint Cartilage Thickness in Healthy Children: Age- and Sex-Related Standard Reference Values. J Rheumatol 1 d\u0026eacute;c. 2010;37(12):2595\u0026ndash;601.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOyamakinde SO, Ibitoye BO, Esan O, Famurewa OC, Aderibigbe AS. High-Resolution ultrasound of knee osteoarthritis in a Southwest Nigerian population: Our experience. J Musculoskelet Surg Res. 2019;3:209.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstitut National de la Statistique et de la D\u0026eacute;mographie (INSD). Cinqui\u0026egrave;me Recensement G\u0026eacute;n\u0026eacute;ral de la Population et de l'Habitation (RGPH): Rapport de pr\u0026eacute;sentation des r\u0026eacute;sultats d\u0026eacute;finitifs [Internet]. Ouagadougou: INSD; 2022. [cit\u0026eacute; 11 janv 2026]. Disponible sur. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.insd.bf/contenu/documents_rgph/Rapport_de_presentation_des_resultats_definitifs_RGPH_2019.pdf\u003c/span\u003e\u003cspan address=\"https://www.insd.bf/contenu/documents_rgph/Rapport_de_presentation_des_resultats_definitifs_RGPH_2019.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePhysical status. the use of and interpretation of anthropometry, report of a WHO expert committee [Internet]. [cit\u0026eacute; 26 d\u0026eacute;c 2025]. Disponible sur: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/publications/i/item/9241208546\u003c/span\u003e\u003cspan address=\"https://www.who.int/publications/i/item/9241208546\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eObservatoire National de l'Activit\u0026eacute; Physique et de la S\u0026eacute;dentarit\u0026eacute; (ONAPS). Guide d'utilisation du questionnaire IPAQ - version courte [Internet]. Clermont-Ferrand: ONAPS ; 2018 [cit\u0026eacute; 11 janv 2026]. Disponible sur : \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.onaps.fr/ressources/outils-d-evaluation\u003c/span\u003e\u003cspan address=\"http://www.onaps.fr/ressources/outils-d-evaluation\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWMA - The World Medical Association. -D\u0026eacute;claration d\u0026rsquo;Helsinki de l\u0026rsquo;AMM \u0026ndash; Principes \u0026eacute;thiques applicables \u0026agrave; la recherche m\u0026eacute;dicale impliquant des participants humains [Internet]. [cit\u0026eacute; 26 d\u0026eacute;c 2025]. Disponible sur: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.wma.net/fr/policies-post/declaration-dhelsinki-de-lamm-principes-ethiques-applicables-a-la-recherche-medicale-impliquant-des-etres-humains/\u003c/span\u003e\u003cspan address=\"https://www.wma.net/fr/policies-post/declaration-dhelsinki-de-lamm-principes-ethiques-applicables-a-la-recherche-medicale-impliquant-des-etres-humains/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBedewi MA, Elsifey AA, Naguib MF, Saleh AK, Al-Ghamdi S, Alhariqi BA, et al. Ultrasonographic measurement of femoral cartilage thickness in type II diabetic patients. Med (Baltimore) avr. 2020;99(14):e19455.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSellam J, Courties A, Eymard F, Ferrero S, Latourte A, Ornetti P, et al. Recommandations de la Soci\u0026eacute;t\u0026eacute; fran\u0026ccedil;aise de rhumatologie sur la prise en charge pharmacologique de la gonarthrose. Rev Rhum d\u0026eacute;c. 2020;87(6):439\u0026ndash;46.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJones G, Glisson M, Hynes K, Cicuttini F. Sex and site differences in cartilage development: A possible explanation for variations in knee osteoarthritis in later life. Arthritis Rheum. 2000;43(11):2543\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCollins AT, Kulvaranon ML, Cutcliffe HC, Utturkar GM, Smith WAR, Spritzer CE, et al. Obesity alters the in vivo mechanical response and biochemical properties of cartilage as measured by MRI. Arthritis Res Ther. oct 2018;17(1):232.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMezhov V, Ciccutini FM, Hanna FS, Brennan SL, Wang YY, Urquhart DM, et al. Does obesity affect knee cartilage? A systematic review of magnetic resonance imaging data. Obes Rev f\u0026eacute;vr. 2014;15(2):143\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCAPTIONS FOR. FIGURES AND TABLES.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-rheumatology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"brhm","sideBox":"Learn more about [BMC Rheumatology](http://bmcrheumatol.biomedcentral.com)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/brhm/default.aspx","title":"BMC Rheumatology","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"articular cartilage, knee, ultrasound, sub-Saharan Africa","lastPublishedDoi":"10.21203/rs.3.rs-8747970/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8747970/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo establish ultrasound reference values for femoral trochlear cartilage thickness in healthy adults of Black African origin and identify factors influencing variation.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003e Cross-sectional study conducted at Bogodogo University Hospital (Burkina Faso) on 506 healthy participants (1,012 knees) aged 18 to 45 years. Thickness was measured by a single radiologist using an ultrasound scanner with a high-frequency linear probe (8\u0026ndash;15 MHz) at the medial condyle (MC), lateral condyle (LC), and intercondylar zone (ICZ). Multiple linear regression was used to analyze the factors associated with variations in thickness.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe population consisted of 408 men (80.63%) and 98 women (19.37%) with a mean age of 24.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.42 years. The mean thickness was 2.36 mm at the MC, 2.38 mm at the LC, and 2.60 mm at the ICA. Bivariate analysis showed significantly thicker cartilage in men (p\u0026thinsp;=\u0026thinsp;0.001). After multivariate adjustment, gender and weight remained positively associated with thickness (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while BMI showed a negative association. Age was no longer significantly associated in the final model.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThis study provides the first ultrasound standards for trochlear cartilage in a sub-Saharan African population. These data constitute an essential paraclinical reference for the early detection of knee osteoarthritis and the interpretation of cartilage measurements in this geographical context.\u003c/p\u003e","manuscriptTitle":"Ultrasound reference values for trochlear cartilage in healthy black African subjects: a study of a cohort of 506 participants","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-02 09:18:22","doi":"10.21203/rs.3.rs-8747970/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-27T15:21:58+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-23T05:47:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"180587170332839588641944006782516036976","date":"2026-04-20T11:48:59+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-16T15:07:38+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-07T06:59:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"192808239227471904152985491067122106802","date":"2026-03-05T10:38:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"151644935119439375977703559012518739272","date":"2026-03-04T08:28:15+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-24T19:24:21+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-03T17:23:24+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-03T15:18:24+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-03T15:17:36+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Rheumatology","date":"2026-01-31T08:12:59+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-rheumatology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"brhm","sideBox":"Learn more about [BMC Rheumatology](http://bmcrheumatol.biomedcentral.com)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/brhm/default.aspx","title":"BMC Rheumatology","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8ebfba07-cc4a-47a0-8da4-9f37577cd654","owner":[],"postedDate":"March 2nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-05T08:54:41+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-02 09:18:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8747970","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8747970","identity":"rs-8747970","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}