Association of Severity of Coexisting Patellofemoral Disease With Increased Impairments and Functional Limitations in Patients With Knee Osteoarthritis
Article first published online: 28 MAR 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 4, pages 544–551, April 2013
How to Cite
Farrokhi, S., Piva, S. R., Gil, A. B., Oddis, C. V., Brooks, M. M. and Fitzgerald, G. K. (2013), Association of Severity of Coexisting Patellofemoral Disease With Increased Impairments and Functional Limitations in Patients With Knee Osteoarthritis. Arthritis Care Res, 65: 544–551. doi: 10.1002/acr.21866
- Issue published online: 28 MAR 2013
- Article first published online: 28 MAR 2013
- Accepted manuscript online: 8 OCT 2012 12:12PM EST
- Manuscript Accepted: 21 SEP 2012
- Manuscript Received: 1 MAR 2012
- NIH. Grant Numbers: 1-R01-AR048760, UL-1RR-024153, UL1-TR-000005
To evaluate the association between severity of coexisting patellofemoral (PF) disease with lower extremity impairments and functional limitations in patients with tibiofemoral (TF) osteoarthritis (OA).
Radiographic views of the TF and PF compartments, knee extension strength, and knee range of motion were obtained for 167 patients with knee OA. Additionally, knee-specific symptoms and functional limitations were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Activities of Daily Living Scale (ADLS).
Moderate/severe PFOA was associated with lower knee extension strength (mean ± SD 1.4 ± 0.5 Nm/body weight [BW]) compared to no PFOA (mean ± SD 1.8 ± 0.5 Nm/BW). Additionally, total knee range of motion was significantly lower for patients with moderate/severe PFOA (mean ± SD 120.8° ± 14.4°) compared to no PFOA (mean ± SD 133.5° ± 10.7°) and mild PFOA (mean ± SD 125.8° ± 13.0°). Moderate/severe PFOA and mild PFOA were also associated with less pain while standing (odds ratio [OR] 0.2, 95% confidence interval [95% CI] 0.1–0.7 and OR 0.2, 95% CI 0.1–0.6, respectively) on the WOMAC, and moderate/severe PFOA was associated with greater difficulty with going downstairs (OR 2.9, 95% CI 1.0–8.1) on the ADLS.
It appears that knees with more severe coexisting PF disease demonstrate features distinct from those observed in TFOA in isolation or in combination with mild PF disease. Treatment strategies targeting the PF joint may be warranted to mitigate the specific lower extremity impairments and functional problems present in this patient population.