Is the degree of osteophyte formation associated with the symptoms and functions in the patellofemoral joint in patients undergoing total knee arthroplasty?

Abstract

Osteophyte formation and loss of articular cartilage are the main pathologic features of osteoarthritis in the patellofemoral joint. The goal of this study was to determine whether the degree of osteophyte formation was associated with the degree of cartilage loss and the patellofemoral symptoms and functions in osteoarthritic patients undergoing total knee arthroplasty (TKA). We evaluated 71 knees in 54 consecutive patients who underwent TKA under the diagnosis of osteoarthritis. The degree of patellofemoral osteophyte formation was assessed by proportional diameter and proportional rim involvement. The cartilage status was assessed by depth and size of the cartilage lesion. The patellofemoral symptoms and functions included anterior knee pain, abilities of chair-rising and stair-climbing and quadriceps muscle power. No significant association was found between the degrees of patellar or trochlear osteophyte formation with anterior knee pain or any of the patellofemoral functional parameters (P>0.05). The degree of osteophyte formation in the patella and the trochlea had a significant but weak correlation with the status of patellar cartilage and the status of the trochlear cartilage, respectively (correlation coefficient = 0.22-0.41 and P<0.05). This study indicates that physicians need to be cautious not to easily reach the conclusion that the patellofemoral symptoms and functional disabilities can be attributed to the presence of osteophyte in the patellofemoral joint in consulting patients with the patellofemoral radiographs or deciding on patellar resurfacing in TKA.

Association between radiological findings and symptoms at the patellofemoral joint in advanced knee osteoarthritis

“…Our previous intra-operative study of patients undergoing TKR for advanced OA found no statistically significant association between the extent of osteophyte formation and anterior knee pain and patellofemoral functional disability. 24 The reason for the discordance between our studies and those by Cicuttini et al 10 and Lanyon et al 11 is not clear, but may reflect differences in the patient populations which were studied. In the study by Cicuttini et al, 10 only 24.2% of knees had evidence of osteophyte formation, and Lanyon et al 11 found that 215 of 452 knees (47.6%) had no radiological evidence of osteophytes.…”

Comparison of Magnetic Resonance Imaging, Computed Tomography, and Radiography for Assessment of Noncartilaginous Changes in Equine Metacarpophalangeal Osteoarthritis

“…The relationship between the development of osteophytosis and cartilage damage remains unclear in the process of osteoarthritis, with conflicting results in different animal models 8,26 and in humans 27,28 . In the present study, the lower correlation seen on MRI compared with CT between osteophytosis and cartilage damage scores could be linked to the fact that grade 1 osteophytes were more often suspected with MRI.…”

Understanding the patellofemoral joint in total knee arthroplasty

“…Another study showed that radiographic changes of patellofemoral osteoarthritis do not correlate with patellofemoral symptoms. 27 Indeed, addressing degenerative articular surface by resurfacing the patella has not universally resolved patellofemoral symptoms. 28,29 Although in many cases we cannot identify the specific cause, pain after TKA has been shown to be associated with certain patient factors.…”