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Thank you for your efforts to address the feedback provided by the reviewers. I am pleased to advise that your amendments and comments have satisfied the reviewers and your manuscript is ready for publication.
[# PeerJ Staff Note - this decision was reviewed and approved by Jeremy Loenneke, a PeerJ Section Editor covering this Section #]
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The manuscript has been properly improved. I suggest only modifying Figure 1 which doesn't represent a 3D model.
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Your manuscript has been reviewed, and we have identified limitations that can be addressed in the analysis and reporting of your work. In particular, it would be helpful to include details about the change in the volume of the IFP rather than just the area. These data provide important insights into the changes following marathon participation. I believe you should be able to calculate these values from the MRI used in your investigation.
The reviewers have suggested the inclusion of additional research. Please use your best judgment to assess whether the suggested references are relevant and valuable.
The reviewers have suggested changes to the formatting and wording of figures to improve readability. Please address these in your response.
Thank you for your submission. We look forward to reviewing your revised manuscript.
[# PeerJ Staff Note: It is PeerJ policy that additional references suggested during the peer-review process should *only* be included if the authors are in agreement that they are relevant and useful #]
Additional articles regarding IFP morphometry must be cited and implemented in the introduction and Discussion sections. For example:
Wallace, K. G., Pfeiffer, S. J., Pietrosimone, L. S., Harkey, M. S., Zong, X., Nissman, D., Kamath, G. M., Creighton, R. A., Spang, J. T., Blackburn, J. T., & Pietrosimone, B. (2021). Changes in Infrapatellar Fat Pad Volume 6 to 12 Months After Anterior Cruciate Ligament Reconstruction and Associations With Patient-Reported Knee Function. Journal of athletic training, 56(11), 1173–1179. https://doi.org/10.4085/1062-6050-0458.20
Fontanella, C. G., Belluzzi, E., Pozzuoli, A., Scioni, M., Olivotto, E., Reale, D., Ruggieri, P., De Caro, R., Ramonda, R., Carniel, E. L., Favero, M., & Macchi, V. (2022). Exploring Anatomo-Morphometric Characteristics of Infrapatellar, Suprapatellar Fat Pad, and Knee Ligaments in Osteoarthritis Compared to Post-Traumatic Lesions. Biomedicines, 10(6), 1369. https://doi.org/10.3390/biomedicines10061369
**PeerJ Staff Note:** It is PeerJ policy that additional references suggested during the peer-review process should only be included if the authors are in agreement that they are relevant and useful.
MAGiC and IDEAL-IQ techniques reported in the abstract are not clear. FF indicates Fat Fraction, so how is it calculated? I suggest modifying this sentence in the abstract and explaining it better in the manuscript. Please specify what it means, not only the software gives these data.
Figures are not significant, because they are repetitive. I suggest reporting only a figure considering pre- post- marathon, and additional figures regarding correlation ore other data.
The manuscript calculated only a cross-sectional area; however, the modification after the marathon can be better explained in terms of volume.
I thank you for providing the raw data; however, the analysis can be implemented and modified. Given the MR at disposal, additional data can be obtained and commented on, such as IFP volume or depth.
The Manuscript is interesting and well-described. However, considering the data at disposal by the authors additional analysis can be done and statistically verified.
“Care was taken to avoid large vessels within the ROI to mitigate partial volume effects”. This sentence is not clear. Please modify it.
In general, the study is clear and well-written.
Abstract
Lines 17-19: “Paired t-tests compared pre- and post-marathon differences, and Pearson correlation analysis explored relationships between IFP parameter changes and participant characteristics (p<0.05).” It is unclear why authors reported (p<0.05) in this sentence.
The captions of the figures should be improved. Figures A and B should be one figure in order to show the figures together on the same page and not in different pages.
Why did authors select to study only cross-sectional area of IFP? It would be important also to evaluate IFP volume.
Line 90: why left knee?
Lines 91-93: here authors reported that participants were instructured to avoid participation to a marathon between the two scans. However, it is reported that participants took a MRI before and after a marathon few lines before. When did participants participate to a marathon? This point should be clarified, considering also the aim of the study.
Line 129: spss software should be cited as reported in website of the producer.
Results
Line 141: “68.29±9.675” please check all the numbers in order to report the same number of decimals after the decimal point.
Line 144: infrapatellar fat pad should be IFP.
Lines 151-152: “These ICC values indicate good to excellent interobserver agreement” this sentence is not a result. It should be moved to the discussion.
Line 155: how did authors evaluate normality? This information should be reported in the statistical analysis section.
Lines 143-144: Did authors check if these participants have cartilage degeneration?
Could the authors perform multivariate analysis to understand the effect of age, BMI ect on FF?
Introduction
Lines 48-49: “Furthermore, dense innervation of the IFP enables it to perceive pain, pressure, and temperature variations, thereby participating in the regulation of knee joint proprioception.” References should be added.
Discussion
Lines 179-180: Macchi et al (reference 6) did not evaluate IFP before and after a marathon. This sentence should be modified.
Lines 208-210: this part should be improved as alterations of IFP area/volume are reported not only in OA but also in other knee conditions (such as ACL rupture, meniscal tears) are reported (doi: 10.3390/biomedicines10061369; doi: 10.1016/j.aanat.2018.09.007 etc).
Authors found that FF increases one week after the marathon. It would be interesting to understand whether this change is maintained over time or is transient.
Lines 210-212: this sentence should be tone down.
In the discussion, the authors continue to refer to the biomechanics of the IFP and the need to better study this aspect, which I also agree with. However, there is a study that has experimentally analyzed the biomechanical behavior of the IFP in OA, which is not even mentioned.
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