Is Patellofemoral Osteoarthritis Common in Middle-Aged People With Chronic Patellofemoral Pain?

Authors

  • Rana S. Hinman,

    Corresponding author
    1. University of Melbourne, Parkville, Victoria, Australia
    • Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Parkville, Victoria 3010, Australia. E-mail: ranash@unimelb.edu.au

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    • Dr. Hinman receives royalties from sales of an educational osteoarthritis DVD and sales of an osteoarthritis shoe.

  • Jonathan Lentzos,

    1. University of Melbourne, Parkville, Victoria, Australia
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  • Bill Vicenzino,

    1. University of Queensland, St. Lucia, Queensland, Australia
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  • Kay M. Crossley

    1. University of Melbourne, Parkville, Victoria, and University of Queensland, St. Lucia, Queensland, Australia
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    • Dr. Crossley has received honoraria (less than $10,000) from DJO Global.


Abstract

Objective

To document the prevalence of radiographic osteoarthritis (OA) in the medial and lateral patellofemoral (PF) joint compartments relative to the prevalence of tibiofemoral (TF) joint OA in middle-aged and older adults with chronic PF knee pain.

Methods

A convenience sample of 224 people who volunteered for a clinical trial underwent weight-bearing posteroanterior and skyline knee radiographs of their most symptomatic eligible knee. Radiographic severity in the TF joint and in the medial and lateral PF joint compartments was independently graded by 2 examiners using the Kellgren/Lawrence (K/L) grading system. K/L grades ≥2 were considered evidence of OA.

Results

OA was common in this cohort, and the most prevalent pattern was combined TF joint and PF joint OA (n = 98 [44%]), followed by isolated PF joint OA (n = 57 [25%]). Isolated TF joint OA was rare. Overall, more people demonstrated radiographic OA in the PF joint (n = 155 [69%]) than in the TF joint (n = 100 [45%]). The majority of people with PF joint OA had OA in both the medial and lateral PF joint compartments (n = 98 [63%]). Even in people ages <50 years, radiographic OA was common (isolated PF joint OA, 26% [n = 21]; combined TF joint and PF joint OA, 29% [n = 23]). The severity of PF joint OA was similar across men and women.

Conclusion

PF joint OA was highly prevalent, more so than TF joint OA, and even in individuals ages <50 years. Further research is needed to elucidate the cause and effect relationship between chronic PF pain and PF joint OA.

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