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- DOI: 10.1002/acr.20214
- PMID: 20506169
- UKPMCID: 20506169
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The association between patella alta and the prevalence and worsening of structural features of patellofemoral joint osteoarthritis: The multicenter osteoarthritis study.
Stefanik, J J; Zhu, Y; Zumwalt, A C; Gross, K D; Clancy, M; Lynch, J A; Law, L A Frey; Lewis, C E; Roemer, F W; Powers, C M; Guermazi, A; Felson, D T
Arthritis Care Res. 2010;62(9):1258-1265.
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Full-text held externally
- DOI: 10.1002/acr.20214
- PMID: 20506169
- UKPMCID: 20506169
Abstract
OBJECTIVE:: To examine the relationship between patella alta and the prevalence and worsening at follow-up of structural features of patellofemoral joint (PFJ) osteoarthritis (OA) on MRI. METHODS:: The Multicenter Osteoarthritis (MOST) Study is a cohort study of persons aged 50-79 years with or at risk for knee OA. Patella alta was measured using the Insall-Salvati ratio (ISR) on the baseline lateral radiograph and cartilage damage, bone marrow lesions (BMLs), and subchondral bone attrition (SBA) were graded on MRI at baseline and at 30 months follow-up in the PFJ. We examined the association of the ISR with the prevalence and worsening of cartilage damage, BMLs, and SBA in the PFJ using logistic regression. RESULTS:: 907 knees were studied (mean age 62, BMI 30, ISR 1.10), 63% from female subjects. Compared with knees in the lowest ISR quartile at baseline, those in the highest had 2.4 (95% CI 1.7, 3.3), 2.9 (2.0, 4.3), and 3.5 (2.3, 5.5) times the odds of having lateral PFJ cartilage damage, BMLs, and SBA respectively, and 1.5 (95% CI 1.1, 2.0), 1.3 (0.9, 1.8), and 2.2 (1.4, 3.4) times the odds of having medial PFJ cartilage damage, BMLs, and SBA respectively. Similarly, those with high ISRs were also at risk for worsening of cartilage damage and BMLs over time than those with low ISRs. CONCLUSION:: A high ISR, indicative of patella alta, is associated with structural features of OA in the PFJ. Additionally, the same knees have increased risk of worsening of these same features over time.