# Patellar and Femoral Bone Morphology Is Associated With Overweight and Sports Participation in Young Adolescents

## TL;DR

This study finds that BMI and sports participation in adolescents are linked to changes in the shape of their knee bones, which could affect musculoskeletal health.

## Contribution

The study identifies specific associations between BMI, sports participation, and 3D bone shape variations in young adolescents using statistical shape modeling.

## Key findings

- BMI was associated with nine patellar and nine femoral shape modes in adolescents.
- Sports participation was linked to specific patellar and femoral shape variations.
- Early and ongoing sports participation was associated with one specific patellar shape mode.

## Abstract

High levels of physical activity or high BMI during puberty could negatively influence bone and cartilage development. Little is known about the effects of loading on patellar and femoral bone shape in a young population. Therefore, we aim to identify the association between 3D patella and femur shape and biomechanical loading in a young adolescent population. Participants were selected from an ongoing cohort study (Generation‐R study). Participants that underwent knee‐MRI at 13 years‐old follow‐up were included. Patellae and femora were segmented from these MRIs and using these 3D models, statistical shape modeling was performed. Generalized estimating equations were used to analyze the association between loading (BMI, physical activity and sports participation) and shape variation. Bonferroni correction was used to correct for multiple testing. 1912 participants underwent MRI of which 3638 patellae and 3355 femora were included in the statistical shape models. Nine patellar (modes 1–7, 10 and 11) and nine femoral (modes 1–3, 6–10 and 14) shape modes were associated with BMI. Sports participation at thirteen years old was associated with one patellar (mode 1) and two femoral (modes 1 and 6) shape modes. One shape mode (mode 12) was associated with sports participation at 9 and 13 years old. Sports participation and BMI were significantly associated with bone shape variations. BMI was associated with most shape variations found in our statistical shape models, emphasizing the significant impact of BMI on bone morphology during adolescence with implications for musculoskeletal health and injury prevention.