The prevalence of patellofemoral osteoarthritis: a systematic review and meta-analysis

Kobayashi, Sarah; Pappas, Evangelos; Fransen, Marlene; Refshauge, Kathryn M.; Simić, Milena

doi:10.1016/j.joca.2016.05.011

Cited by 110 publications

(76 citation statements)

References 57 publications

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“…The current systematic review extends on the results from a prior study 7. The previous systematic review reported the radiographic prevalence of PF OA in population-based and symptom- based population; whereas, the current review reported prevalence of PF OA in multiple different populations.…”

Section: Discussionmentioning

confidence: 71%

“…A large number of studies have reported PF OA in different populations (eg, post-traumatic and healthy individuals), and knowledge of population-specific prevalence is relevant for clinicians and researchers. An updated review with inclusion of different study samples (eg, post-traumatic, occupation-based, high risk of OA and healthy individuals) builds considerably on the previous systematic review7 and extends our current knowledge of PF OA.…”

Section: Introductionmentioning

confidence: 99%

“…A 2013 narrative literature review concluded that the prevalence of radiographic PF OA in individuals’ post-ACL and/or meniscus ruptures was approximately 50% 6. A recent systematic review described the prevalence of radiographic PF OA in population-based and in cohorts of people with knee pain 7. A large number of studies have reported PF OA in different populations (eg, post-traumatic and healthy individuals), and knowledge of population-specific prevalence is relevant for clinicians and researchers.…”

Section: Introductionmentioning

confidence: 99%

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The prevalence of radiographic and MRI-defined patellofemoral osteoarthritis and structural pathology: a systematic review and meta-analysis

et al. 2017

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BackgroundPatellofemoral osteoarthritis (PF OA) is more prevalent than previously thought and contributes to patient’s suffering from knee OA. Synthesis of prevalence data can provide estimates of the burden of PF OA.ObjectiveThis study aims to conduct a systematic review and meta-analysis on the prevalence of PF OA and structural damage based on radiography and MRI studies in different populations.MethodsWe searched six electronic databases and reference lists of relevant cross-sectional and observational studies reporting the prevalence of PF OA. Two independent reviewers appraised methodological quality. Where possible, data were pooled using the following categories: radiography and MRI studies.ResultsEighty-five studies that reported the prevalence of patellofemoral OA and structural damage were included in this systematic review. Meta-analysis revealed a high prevalence of radiographic PF OA in knee pain or symptomatic knee OA (43%), radiographic knee OA or at risk of developing OA (48%) and radiographic and symptomatic knee OA (57%) cohorts. The MRI-defined structural PF damage in knee pain or symptomatic population was 32% and 52% based on bone marrow lesion and cartilage defect, respectively.ConclusionOne half of people with knee pain or radiographic OA have patellofemoral involvement. Prevalence of MRI findings was high in symptomatic and asymptomatic population. These pooled data and the variability found can provide evidence for future research addressing risk factors and treatments for PF OA.Trial registration numberPROSPERO systematic review protocol (CRD42016035649).

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The prevalence of radiographic and MRI-defined patellofemoral osteoarthritis and structural pathology: a systematic review and meta-analysis

et al. 2017

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“…The patellofemoral (PF) joint is among the most common sites of radiographic osteoarthritis (OA) with a prevalence of 25% in general population aged more than 20-years 1 . Magnetic resonance imaging (MRI) and its application in assessment of the knee joint showed that early Patellofemoral (PF)-OA-related structural damages are seen among a larger proportion of population than what was previously reported 2 .…”

Section: Introductionmentioning

confidence: 99%

Association of patella alta with worsening of patellofemoral osteoarthritis-related structural damage: data from the Osteoarthritis Initiative

Haj‐Mirzaian

Guermazi

Pishgar

et al. 2019

Osteoarthritis and Cartilage

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s u m m a r yObjectives: To determine the association between Insall-Salvati ratio (ISR), a measure of patella alta, and worsening of Magnetic Resonance Imaging (MRI)-based osteoarthritis (OA)-related patellofemoral joint structural damages over 24-month in participants of the Osteoarthritis Initiative (OAI). Design: Using weighted random sampling method, we selected a sample of 500 knees (from 1,677 knees with available baseline and 24-months MRI OA Knee Score (MOAKS) measurements), which is OAIrepresentative regarding knee OA-related factors (i.e., baseline age, sex, body mass index (BMI), and radiographic KellgreneLawrence grading). The ISR was measured in all enrolled knees using baseline sagittal 3T-MRI plane by three radiologists. Baseline and 24-month MOAKS variables for patellofemoral bone marrow lesions (BMLs), cartilage damages, and osteophytes were extracted, and the associations between ISR and 24-month worsening of these 3T-MRI features were evaluated using multivariable regression models. After computing receiver operating characteristic curves, the optimal cutoff point of ISR for indicating worsening of patellofemoral OA was determined. P-values were adjusted for multiple comparisons and false discovery rate (FDR) adjusted P-values were reported. Results: In this longitudinal analysis, 24-month worsening of BML (odds ratio [OR] (95% confidence interval [95% CI]):11.18 (3.35e39.6), adjusted-p-value:<0.001) and cartilage scores (OR:7.39 (1.62e34.71), adjusted-p-value:0.042) in lateral patella was associated with higher baseline ISR. However, higher ISR was not statistically associated with medial patellar or medial and lateral trochlear BML or cartilage scores worsening. We determined the optimal cutoff point of ISR!1.14 (95% CI: 1.083e1.284) for predicting lateral patellofemoral OA-related structural damages worsening over 24-months (sensitivity:73.73%; specificity: 66.67%). Conclusions: Given the uncertainly surrounding the results, our overall findings suggest that ISR could be considered as a predictor of lateral patellofemoral OA-related structural damages worsening with the optimal cutoff point of !1.14 using knee sagittal MRI measurements.

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“…However, the joint motion (with or without muscle contraction) is not restricted and mechanical stress, such as shear and compressive forces, on the articular cartilage cannot be completely eliminated. These mechanical stresses affect the metabolism of the normal articular cartilage 41,42 ; moreover, Kobayashi et al reported that the PF and TF joints exhibit various structural, pathomechanical, and clinical characteristics 43 . Therefore, it may be possible that the environmental conditions of this experiment, such as the unloading condition where the joint motion (with or without muscle contraction) is possible, may have influenced the difference of suppression effect exhibited by joints and sites.…”

Section: Discussionmentioning

confidence: 99%

Joint unloading inhibits articular cartilage degeneration in knee joints of a monosodium iodoacetate-induced rat model of osteoarthritis

Takahashi

Matsuzaki

Kuroki

et al. 2019

Osteoarthritis and Cartilage

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s u m m a r yObjective: The aim of the study was to examine how mechanical unloading affects articular cartilage degeneration in the patellofemoral (PF) and tibiofemoral (TF) joints of a monosodium iodoacetate (MIA)induced rat model of osteoarthritis (OA). Design: The study involved 60 male rats. OA was induced by intra-articular injecting MIA into both knee joints. All animals were equally divided into two groups: sedentary (SE) and hindlimb unloading (HU) groups. Histopathological changes in the articular cartilage of the PF and TF joints were evaluated using the Osteoarthritis Research Society International (OARSI) score and modified Mankin score at 2 and 4 weeks after MIA injection. Results: In the SE and HU groups, representative histopathological changes in OA were detected in the PF and TF joints. The OARSI and modified Mankin scores for the PF and TF joints tended to increase over time after the injection of 0.2 mg or 1.0 mg of MIA in the SE and HU groups. Both the scores for the HU group were significantly lower than those for the SE group [OARSI score: P < 0.0001 (1.0-mg injection at 4 weeks); modified Mankin score: P ¼ 0.0116 (0.2-mg injection at 4 weeks); P ¼ 0.0004 and < 0.0001 (1.0-mg injection at 2 and 4 weeks, respectively)]. Conclusion: This study revealed new histological evidence that indicates that unloading condition suppresses articular cartilage degeneration and is beneficial in many areas of basal and clinical research involving OA.

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The prevalence of patellofemoral osteoarthritis: a systematic review and meta-analysis

Abstract: These findings confirm the substantial prevalence of patellofemoral OA, demonstrating the need to specifically consider the patellofemoral joint in knee OA research and clinical settings.

Cited by 110 publications

References 57 publications

The prevalence of radiographic and MRI-defined patellofemoral osteoarthritis and structural pathology: a systematic review and meta-analysis

The prevalence of radiographic and MRI-defined patellofemoral osteoarthritis and structural pathology: a systematic review and meta-analysis

Association of patella alta with worsening of patellofemoral osteoarthritis-related structural damage: data from the Osteoarthritis Initiative

Joint unloading inhibits articular cartilage degeneration in knee joints of a monosodium iodoacetate-induced rat model of osteoarthritis

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