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Skeletal Assessment and Secular Changes in Knee Development: A Radiographic Approach

NCJ Number
American Journal of Physical Anthropology Volume: 162 Issue: 2 Dated: February 2017 Pages: 229-240
Date Published
February 2017
12 pages
The purpose of this study was to analyze ossification patterns in the distal femoral, proximal tibial, and proximal fibular epiphyses, as well as the patella.
Using the Pediatric Radiology Interactive Atlas (Patricia), a total of 1,317 epiphyses were scored for presence or absence from radiographs of 1,056 White individuals born in or after 1990. Using logistic regression, statistical modeling of epiphyseal appearance was conducted for all major percentiles, including the 5th and 95th percentiles. Compared with Elgenmark (1946) and Garn et al. (1967), data from the current study suggest that the distal femoral and proximal tibial epiphyses show overall earlier ossification, and the proximal fibular epiphysis shows later ossification. When examining the pooled sex 50th percentile for the data, ossification timing differences were 1.2 weeks earlier in the distal femoral epiphysis, 2.1 weeks earlier in the proximal tibial epiphysis, and 1.4 years later in the proximal fibular epiphysis. The epiphyses that appear early in life, such as the distal femoral epiphysis, require gestational age information to accurately estimate appearance times. There are considerable differences between the ossification timing patterns presented in this study and those of previous standards, which did not include gestational ages. Several factors may explain the observed differences in the epiphyses of the knee, including the availability of gestational age information, the analysis of longitudinal versus cross-sectional data, differences in socioeconomic status and prenatal care, and secular change. (Publisher abstract modified)

Date Published: February 1, 2017