Dr. Roemer owns stock and/or holds stock options in Boston Imaging Core Labs, LLC.
Association between patella alta and the prevalence and worsening of structural features of patellofemoral joint osteoarthritis: The multicenter osteoarthritis study
Article first published online: 2 SEP 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis Care & Research
Volume 62, Issue 9, pages 1258–1265, September 2010
How to Cite
Stefanik, J. J., Zhu, Y., Zumwalt, A. C., Gross, K. D., Clancy, M., Lynch, J. A., Frey Law, L. A., Lewis, C. E., Roemer, F. W., Powers, C. M., Guermazi, A. and Felson, D. T. (2010), Association between patella alta and the prevalence and worsening of structural features of patellofemoral joint osteoarthritis: The multicenter osteoarthritis study. Arthritis Care Res, 62: 1258–1265. doi: 10.1002/acr.20214
- Issue published online: 2 SEP 2010
- Article first published online: 2 SEP 2010
- Accepted manuscript online: 9 APR 2010 12:00AM EST
- Manuscript Accepted: 29 MAR 2010
- Manuscript Received: 18 DEC 2009
- NIH. Grant Numbers: U01-AG18820, U01-AG18832, U01-AG18947, U01-AG19069, AR-47785
- Doctoral dissertation award from the Arthritis Foundation
To examine the relationship between patella alta and the prevalence and worsening at followup of structural features of patellofemoral joint (PFJ) osteoarthritis (OA) on magnetic resonance imaging (MRI).
The Multicenter Osteoarthritis Study is a cohort study of persons ages 50–79 years with or at risk for knee OA. Patella alta was measured using the Insall-Salvati ratio (ISR) on the baseline lateral radiograph, and cartilage damage, bone marrow lesions (BMLs), and subchondral bone attrition (SBA) were graded on MRI at baseline and at 30 months of followup in the PFJ. We examined the association of the ISR with the prevalence and worsening of cartilage damage, BMLs, and SBA in the PFJ using logistic regression.
A total of 907 knees were studied (mean age 62 years, body mass index 30 kg/m2, ISR 1.10), 63% from female subjects. Compared with knees in the lowest ISR quartile at baseline, those in the highest quartile had 2.4 (95% confidence interval [95% CI] 1.7–3.3), 2.9 (95% CI 2.0–4.3), and 3.5 (95% CI 2.3–5.5) times the odds of having lateral PFJ cartilage damage, BMLs, and SBA, respectively, and 1.5 (95% CI 1.1–2.0), 1.3 (95% CI 0.9–1.8), and 2.2 (95% CI 1.4–3.4) times the odds of having medial PFJ cartilage damage, BMLs, and SBA, respectively. Similarly, those with high ISRs were also at risk for worsening of cartilage damage and BMLs over time than those with low ISRs.
A high ISR, indicative of patella alta, is associated with structural features of OA in the PFJ. Additionally, the same knees have an increased risk of worsening of these same features over time.