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- DOI: 10.1002/acr.20528
- PMID: 21702087
- UKPMCID: 21702087
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Quadriceps weakness, patella alta and structural features of patellofemoral osteoarthritis: The multicenter osteoarthritis study.
Stefanik, Joshua J; Guermazi, Ali; Zhu, Yanyan; Zumwalt, Ann C; Gross, K Douglas; Clancy, Margaret; Lynch, John A; Segal, Neil A; Lewis, Cora E; Roemer, Frank W; Powers, Christopher M; Felson, David T
Arthritis care & research. 2011;63(10):1391-1397.
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Full-text held externally
- DOI: 10.1002/acr.20528
- PMID: 21702087
- UKPMCID: 21702087
Abstract
OBJECTIVE: To determine the relationship between quadriceps weakness and cartilage damage and bone marrow lesions (BMLs) in the patellofemoral joint (PFJ), and if this relationship is modified by patella alta. METHODS: The Multicenter Osteoarthritis (MOST) Study is a cohort study of persons aged 50-79 years with or at risk for knee OA. Concentric knee extensor strength was measured using an isokinetic dynamometer. Patella alta was measured using the Insall-Salvati ratio (ISR) on the lateral radiograph, and cartilage damage and bone marrow lesions (BMLs) were graded on MRI in the PFJ. We determined the association between quadriceps weakness with cartilage damage and BMLs in the PFJ among those knees with (ISR≥1.2) and without patella alta (ISR<1.2) using multiple binomial regression. RESULTS: 807 knees were studied (mean age 62 years, BMI 30, ISR 1.10), 64% from female subjects. Compared with knees in the highest strength tertile, those in the lowest had 10.2% {95% Confidence Interval (CI) 3-18}, 9.1% (95% CI 2-16), and 7.1% (95% CI 1-13) higher prevalence of lateral PFJ cartilage damage, medial PFJ cartilage damage, and lateral PFJ BMLs, respectively. The association between quadriceps weakness with cartilage damage and BMLs was not different between knees with and with out patella alta in the lateral PFJ. CONCLUSION: Quadriceps weakness was associated with PFJ cartilage damage and BMLs. While both patella alta and quadriceps weakness are associated with PFJ damage, the combination of the two was not associated with more damage than either of these factors alone.