Associations of trochlea morphology and patellofemoral alignment with prevalent radiographic patellofemoral osteoarthritis

Zhao, Chenwei; Gao, Xiaoping; Liu, Q.; Li, Z.; Qiu, Yudian; Li, R.; Niu, Jingbo; Stefanik, J.J.; Zhang, Y.; Han, Wenchao; Lin, Jianhao

doi:10.1016/j.joca.2020.01.018

Cited by 13 publications

(12 citation statements)

References 32 publications

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“…In this study, type III patellar morphology is associated with more severe lateral PFOA. A previous study showed that Wiberg patella type III, which presented a medial border dysplasia or a short patellar apex, is more often involved in patients with patellar dislocation [ 29 ], and patella lateral displacement is associated with more severe lateral PFOA [ 30 ]. On the other hand, Wiberg type III patella presented only a small amount of contact with the medial femoral condyle due to the low surface area of the medial facet, which increased the contact pressure of the lateral patella facet on the lateral femoral condyle during knee flexion.…”

Section: Discussionmentioning

confidence: 99%

Association of patellofemoral morphology and alignment with the radiographic severity of patellofemoral osteoarthritis

Dai

Yin

et al. 2021

J Orthop Surg Res

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Background Risk factors for the severity of patellofemoral osteoarthritis (PFOA) are poorly understood. This research aims to evaluate the association between patellofemoral joint (PFJ) morphology and alignment with the radiographic severity of PFOA. Methods A retrospective analysis of CT scan and lateral radiograph data were acquired in patients with PFOA. The radiographic grade of PFOA and tibiofemoral osteoarthritis (TFOA), lateral and medial trochlear inclination angle, sulcus angle, and the Wiberg classification of patella morphology, the congruence angle, patellar tilt angle, and lateral patellar angles, and tibial tubercle trochlear groove distance (TT-TG) and patella height (i.e., Caton-Deschamps index) were assessed using CT scans and sagittal radiographs of the knee. All the PFJ morphology and alignment data were divided into quarters, and the relationships between each of these measures and the severity of PFOA were investigated. Results By studying 150 patients with PFOA, we found a U-shaped relationship between the Caton-Deschamps index and the severity of PFOA (P < 0.001). A lower value of sulcus angle and lateral patellar angle, a higher value of congruence angle, and type III patella were associated with more severity of lateral PFOA. Compared with the highest quarter of each measure, the adjusted odds ratios (OR) of the severity of PFOA in the lowest quarter of sulcus angle, lateral patellar angle, and congruence angle; and type I patella was 8.80 (p = 0.043), 16.51 (P < 0.001), 0.04 (P < 0.001), and 0.18 (p = 0.048) respectively. Conclusions Extreme value of patella height, a higher value of lateral patellar displacement and lateral patellar tilt, lower value of sulcus angle, and type III patella were associated with more severity of PFOA.

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Section: Discussionmentioning

confidence: 99%

Association of patellofemoral morphology and alignment with the radiographic severity of patellofemoral osteoarthritis

Dai

Yin

et al. 2021

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…In this study, type III patellar morphology is associated with more severe lateral PFOA. A previous study showed that Wiberg patella type III, which presented a medial border dysplasia or a short patellar apex, are more often involved in patients with patellar dislocation [29], and patella lateral displacement is associated with more severe lateral PFOA [30]. On the other hand, Wiberg type III patella presented only a small amount of contact with the medial femoral condyle due to the low surface area of the medial facet, which increased the contact pressure of the lateral patella facet on the lateral femoral condyle during knee exion.…”

Section: Discussionmentioning

confidence: 99%

Association of Patellofemoral Morphology and Alignment With the Radiographic Severity of Patellofemoral Osteoarthritis

Dai

Yin

et al. 2021

Preprint

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Background: Risk factors for the progression of patellofemoral osteoarthritis (PFOA) are poorly understood. This research aims to evaluate the association between patellofemoral joint (PFJ) morphology and alignment with the radiographic severity of PFOA.Methods: A retrospective analysis of CT scan and lateral radiograph data were acquired in patients with PFOA. The radiographic severity of PFOA and tibiofemoral OA (TFOA), lateral and medial trochlear inclination angle, sulcus angle and the Wiberg classification of patella morphology, the congruence angle, patellar tilt angle, and lateral patellar angles, and tibial tubercle trochlear groove distance (TT-TG), patella height (i.e., Caton-Deschamps index) were assessed using CT scans and sagittal radiographs of the knee. All the PFJ morphology and alignment data were divided into quarters and the relationship between each measure and the severity of PFOA was investigated.Results: By studying 150 patients with PFOA, we found a U-shaped relationship between the Caton-Deschamps index and the severity of PFOA (P <0.001). A lower value of sulcus angle and lateral patellar angle, a higher value of congruence angle, and type III patella were associated with more severity of lateral PFOA. Compared with the highest quarter of each measure, the adjusted odds ratios (OR) of the severity of PFOA in the lowest quarter of sulcus angle, lateral patellar angle, and congruence angle, and type I patella was 8.80 (p=0.043), 16.51 (P <0.001), 0.04(P <0.001), and 0.18 (p=0.048) respectively.Conclusions: Extreme value of patella height, a higher value of lateral patellar displacement and lateral patellar tilt, lower value of sulcus angle, and type III patella were associated with more severity of PFOA.

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“…It can develop in isolation or in combination with tibiofemoral osteoarthritis (TFOA). The patellofemoral joint (PFJ) has a unique configuration, so its susceptibility to developing symptoms of knee OA is higher than that in patients with TFOA (1–6). The treatment options for patients with PFOA vary according to the location of the lesion and degree of joint derangement (4,7).…”

Section: Introductionmentioning

confidence: 99%

Automatic diagnosis and grading of patellofemoral osteoarthritis from the axial radiographic view: a deep learning-based approach

et al. 2022

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Background Patellofemoral osteoarthritis (PFOA) has a high prevalence and is assessed on axial radiography of the patellofemoral joint (PFJ). A deep learning (DL)-based approach could help radiologists automatically diagnose and grade PFOA via interpreting axial radiographs. Purpose To develop and assess the performance of a DL-based approach for diagnosing and grading PFOA on axial radiographs. Material and Methods A total of 1280 (dataset 1) axial radiographs were retrospectively collected and utilized to develop the high-resolution network (HRNet)-based classification models. The ground truth was the interpretation from two experienced radiologists in consensus according to the K-L grading system. A binary-class model was trained to diagnose the presence (K-L 2∼4) or absence (K-L 0∼1) of PFOA. A multi-class model was used to grade the stage of PFOA, i.e. from K-L 0 to K-L 4. Model performances were evaluated using the receiver operating characteristics (ROC), confusion matrix, and the corresponding evaluation metrics (positive predictive value [PPV], negative predictive value [NPV], F1 score, sensitivity, specificity, accuracy) of the internal test set (n = 129) from dataset 1 and an external validation set (dataset 2, n = 187). Results For the binary-class model, the area under the curve (AUC) was 0.91 in the internal test set and 0.90 in the external validation set. For grading PFOA, moderate to severe stage of PFOA exhibited a good performance in these two datasets (AUC = 0.91–0.98, PPV = 0.69–0.90, NPV = 0.92–0.99, F1 score = 0.72–0.87, sensitivity = 0.75–0.87, specificity = 0.90–0.99, accuracy = 0.87–0.98). Conclusion The HRNet-based approach performed well in diagnosing and grading radiographic PFOA, especially for the moderate to severe cases.

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Associations of trochlea morphology and patellofemoral alignment with prevalent radiographic patellofemoral osteoarthritis

Cited by 13 publications

References 32 publications

Association of patellofemoral morphology and alignment with the radiographic severity of patellofemoral osteoarthritis

Association of patellofemoral morphology and alignment with the radiographic severity of patellofemoral osteoarthritis

Association of Patellofemoral Morphology and Alignment With the Radiographic Severity of Patellofemoral Osteoarthritis

Automatic diagnosis and grading of patellofemoral osteoarthritis from the axial radiographic view: a deep learning-based approach

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