Age-Dependent Susceptibility to Mechanical Unloading-Induced Femoral Morphological Changes and Patellar Instability...

Abnormal bone morphology and joint malalignment are key risk factors for several musculoskeletal disorders, including patellar instability and lateral patellar dislocation (LPD). Insufficient weight loading can affect bone formation in immature joints; however, its impact on mature joints remains unclear. The aim of this study was to compare the effects of hindlimb suspension (HS) on femur morphology and knee alignment associated with patellar instability and LPD in rats with different levels of musculoskeletal maturity. Immature (4-week-old) and mature (12-week-old) female rats underwent 8 weeks of HS. Age-matched untreated rats served as controls. Both knee joints were harvested and analyzed using computed tomography. Anatomical risk factors for patellar dislocation and LPD, including the femoral anteversion angle (FeAV), lateral trochlear inclination (LTI), patellar tilt angle (PTA), bisect offset (BO), and tibial tuberosity-trochlear groove (TT-TG) distance, were measured. After HS, LPD was observed in five of eight knees of immature rats (p < 0.05), whereas no LPD was observed in mature rats. An increased FeAV, PTA, BO, and TT-TG distance, as well as decreased LTI, were observed in the HS knees of immature rats. In contrast, in mature rats, only LTI was significantly lower. Correlation analysis demonstrated strong to moderate relationships between the FeAV and other parameters in immature rats, whereas no significant relationships were detected in mature rats. These findings suggest that insufficient weight loading during skeletal immaturity predisposes individuals to morphological alterations associated with patellar instability, whereas mature joints appear resistant to such changes.