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Clinical Impact of Coexisting Patellofemoral Osteoarthritis in Japanese Patients With Medial Knee Osteoarthritis
Author(s) -
Iijima Hirotaka,
Fukutani Naoto,
Aoyama Tomoki,
Fukumoto Takahiko,
Uritani Daisuke,
Kaneda Eishi,
Ota Kazuo,
Kuroki Hiroshi,
Matsuda Shuichi
Publication year - 2016
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22691
Subject(s) - medicine , osteoarthritis , knee pain , odds ratio , knee joint , confidence interval , patellofemoral pain syndrome , range of motion , logistic regression , physical therapy , surgery , pathology , alternative medicine
Objective To evaluate the clinical impact in knee osteoarthritis (OA) of coexisting patellofemoral (PF) joint OA (PFOA) in Japanese patients with medial tibiofemoral (TF) joint OA (TFOA). Methods Patients with medial knee OA (n = 143) were enrolled. The radiographic severity of the TF and PF joints, anatomic axis angle of the TF joint, patellar alignment, trochlear morphology, patellar height, and passive range of motion (ROM) of the painful knee were evaluated. Additionally, the Japanese Knee Osteoarthritis Measure (JKOM) was used to investigate the association between the presence of PFOA and clinical symptoms. Results PFOA was present in 98 of 143 patients (68.5%) with medial knee OA. Quantile regression analysis revealed that coexisting PFOA was associated with the pain‐related subcategory of the JKOM. Furthermore, multiple logistic regression analysis showed that coexisting PFOA was associated with higher odds of reporting knee pain on using stairs while ascending (odds ratio [OR] 4.81 [95% confidence interval (95% CI) 1.73, 14.3]) and descending (OR 3.86 [95% CI 1.44, 10.8]). A more varus knee alignment and lower knee flexion ROM, which are features of patients with coexisting PFOA, were associated with knee pain while ascending/descending stairs. However, patellar alignment, trochlear morphology, and patellar height were not significantly associated with knee pain. Conclusion PFOA coexisting with medial knee OA was associated with worse clinical symptoms, particularly while ascending/descending stairs, although patellar alignment did not contribute to reporting knee pain. Further studies that include evaluation of the PF joint are warranted to develop a basis for an optimal intervention based on compartmental involvement.