Association between patellofemoral osteoarthritis with demographic features and anatomical variants of the knee in non-traumatic patients

Ghazaleh Jamalipour Soufi; Ali Hekmatnia; Farzaneh Hekmatnia; Andrew Parviz Zarei; Mahshid Bahrami; Sina Rasti; Farshad Riahi

doi:10.62347/XBFS6691

Association between patellofemoral osteoarthritis with demographic features and anatomical variants of the knee in non-traumatic patients

Int J Physiol Pathophysiol Pharmacol. 2023 Dec 15;15(6):142-149. doi: 10.62347/XBFS6691. eCollection 2023.

Authors

Ghazaleh Jamalipour Soufi¹, Ali Hekmatnia¹, Farzaneh Hekmatnia², Andrew Parviz Zarei³, Mahshid Bahrami¹, Sina Rasti¹, Farshad Riahi¹

Affiliations

¹ Department of Radiology, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.
² Department of Radiology, St George's Hospital London, UK.
³ Department of Medicine, The Princes Alexandra Hospital London, UK.

Abstract

Background: Patellofemoral osteoarthritis (PFOA) is a common cause of knee discomfort and impairment, particularly among athletes. The development of PFOA has been associated with anatomical knee variations, such as trochlear dysplasia and patella alta. However, the relationship between these anatomical variants and the development of PFOA remains poorly understood. This study aimed to investigate the association between PFOA and knee anatomical variants in a cohort of patients.

Methods: The study included 200 patients with PFOA and 200 healthy controls. In this study, we investigate the relationship of osteoarthritis with both anatomical variants and demographic characteristics. The participants underwent Magnetic resonance imaging (MRI) evaluation of the knee, and anatomical variants including trochlear dysplasia and patella alta were assessed. The severity of PFOA was also graded based on cartilage area and depth, as well as the bone marrow involvement and presence of osteophytes.

Results: Statistically significant differences were observed between the two groups in terms of Tibial tuberosity-trochlear groove (TT-TG) distance, patella position, trochlear dysplasia, and Insall-Salvati ratio. The mean TT-TG distance, prevalence of alta patella position, and Insall-Salvati ratio were significantly higher in cases (P<0.001 for all), and cases had a higher incidence of trochlear dysplasia (P<0.001). There were no significant differences between cases and controls regarding patella baja.

Conclusion: Anatomical knee variants, including the TT-TG distance, trochlear dysplasia, and Insall-Salvati ratio, are significant risk factors for PFOA progression. The results also indicate that higher BMI and older age are significantly associated with more measures of MRI Osteoarthritis Knee Score (MOAKS) than demographic information. Among anatomical variants, a higher TT-TG distance and an increased grade of trochlear dysplasia show a significant relationship with more measures of MOAKS. Understanding the relationship between these factors has important clinical and research implications and can help inform the development of new treatments.

Keywords: Osteoarthritis; anatomical variants; anatomy; demographic features; patellofemoral.