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Cadaveric assessment of osteoarthritic changes in the patello-femoral joint: evaluation of 203 knees

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to determine the prevalence, type of lesion, and depth of osteoarthritic (OA) changes in the patello-femoral (PF) joint.

Methods

Two hundred and three cadaveric knees were included in this study with median age of 84 years (54–97). Patella OA lesions were classified using Han’s method: (Type 1) no or minimal lesion, (Type 2) medial facet lesion without involvement of the ridge, (Type 3) lateral facet lesion without involvement of the ridge, (Type 4) lesion involvement of the ridge, (Type 5) medial facet lesion with involvement of the ridge, (Type 6) lateral facet lesion with involvement of the ridge, (Type 7) global lesion. Femoral side OA lesions in the PF joint were classified using modified Chang’s method: (Type 1) no or minimal lesion, (Type 2) medial facet lesion, (Type 3) centre of patella groove lesion, (Type 4) lateral facet lesion, (Type 5) global lesion. OA depth evaluation was performed following Outerbridge’s classification.

Results

OA lesions of the patella were observed as follows: (Type 1) 31 %, (Type 2) 16 %, (Type 3) 3 %, (Type 4) 12 %, (Type 5) 22 %, (Type 6) 2 %, (Type 7) 14 %. Outerbridge’s classification of over Grade 2 OA depth was observed in 75.9 % of subjects. Femoral side OA lesions of the PF joint were observed as follows: (Type 1) 42 %, (Type 2) 20 %, (Type 3) 26 %, (Type 4) 2 %, (Type 5) 11 %. Outerbridge’s classification of over Grade 2 OA depth was observed in 58 % of subjects.

Conclusion

Patella OA and femoral side OA in the PF joint occurred mainly on the medial side. Isolated OA in the lateral facet of the PF joint was exceedingly rare. Female subjects had a greater incidence of severe PF-OA than male subjects, and therefore, the physicians should pay attention when they treat the female subjects not to advance the PF-OA.

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Abbreviations

OA:

Osteoarthritis

PF:

Patello-femoral

References

  1. Chang CB, Seong SC, Kim TK (2008) Evaluations of radiographic joint space-do they adequately predict cartilage conditions in the patellofemoral joint of the patients undergoing total knee arthroplasty for advanced knee osteoarthritis? Osteoarthr Cartil 16:1160–1166

    Article  PubMed  CAS  Google Scholar 

  2. Cicuttini FM, Wang YY, Forbes A, Wluka AE, Glisson M (2003) Comparison between patella cartilage volume and radiological assessment of the patellofemoral joint. Clin Exp Rheumatol 21:321–326

    PubMed  CAS  Google Scholar 

  3. Elahi S, Cahue S, Felson DT, Enqelman L, Sharma L (2000) The association between varus-valgus alignment and patellofemoral osteoarthritis. Arthritis Rheum 43:1874–1880

    Article  PubMed  CAS  Google Scholar 

  4. Han I, Chang CB, Lee S, Lee MC, Seong SC, Kim TK (2005) Correlation of the condition of the patellar articular cartilage and patellofemoral symptoms and function in osteoarthritic patients undergoing total knee arthroplasty. J Bone Joint Surg [Br]. 87B:1081–1084

    Google Scholar 

  5. Hashikawa T, Osaki M, Ye Z et al (2011) Factors associated with radiographic osteoarthritis of the knee among community-dwelling Japanese women: the Hizen-Oshima study. J Orthop Sci 16:51–55

    Article  PubMed  Google Scholar 

  6. Hayashi D, Guermazi A, Hunter DJ (2011) Osteoarthritis year 2010 in review: imaging. Osteoarthr Cartil 19:354–360

    Article  PubMed  CAS  Google Scholar 

  7. Kalichman L, Zhang Y, Niu J et al (2007) The association between patellar alignment and patellofemoral joint osteoarthritis features-an MRI study. Rheumatology (Oxford) 46:1303–1308

    Article  CAS  Google Scholar 

  8. Li L, Patil S, Steklov N et al (2011) Computational wear simulation of patellofemoral articular cartilage during in vitro testing. J Biomech 44:1507–1513

    Article  PubMed  Google Scholar 

  9. Misra AN, Smith RB, Fiddian NJ (2003) Five year results of selective patellar resurfacing in cruciate sparing total knee replacements. Knee 10:199–203

    Article  PubMed  CAS  Google Scholar 

  10. Mitrovic D, Stankovic A, Borda-Iriarte O, Uzan M, Quintero M, Ryckewaert A (1987) Results of autopsy examination of knee cartilage in 120 patients dying in the hospital. I. Femoro-patellar joint. Rev Rheum Mal Osteoartic 54:15–21

    CAS  Google Scholar 

  11. Muraki S, Oka H, Akune T et al (2009) Prevalence of radiographic knee osteoarthritis and its association with knee pain in the elderly of Japanese population-based cohorts: the ROAD study. Osteoarthr Cartil 17:1137–1143

    Article  PubMed  CAS  Google Scholar 

  12. Nagamine R, Miyanishi K, Miura H, Urabe K, Matsuda S, Iwamoto Y (2003) Medial torsion of the tibia in Japanese patients with osteoarthritis of the knee. Clin Orthop Relat Res 408:218–224

    Article  PubMed  Google Scholar 

  13. Neuman P, Kostogiannis I, Friden T, Roos H, Dahlberg LE, Englund M (2009) Patellofemoral osteoarthritis 15 years after anterior cruciate ligament injury-a prospective cohort study. Osteoarthr Cartil 17:284–290

    Article  PubMed  CAS  Google Scholar 

  14. Oakley SP, Portek I, Szomor Z et al (2003) Accuracy and reliability of arthroscopic estimates of cartilage lesion size in a plastic knee simulation model. Arthroscopy 19:282–289

    Article  PubMed  Google Scholar 

  15. Oka S, Muratsu H, Matsumoto T et al (2012) The influence of patellar position on soft tissue balance in minimal incision total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 20:1064–1068

    Article  PubMed  Google Scholar 

  16. Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg 43-B:752–757

    CAS  Google Scholar 

  17. Swan JD, Stoney JD, Lim K, Dowsey MM, Choong PF (2010) The need for patellar resurfacing in total knee arthroplasty: a literature review. ANZ J Surg 80:223–233

    Article  PubMed  Google Scholar 

  18. Tanamas S, Hanna FS, Cicuttini FM, Wluka AE, Berry P, Urquhart DM (2009) Does knee malalignment increase the risk of development and progression of knee osteoarthritis? A systematic review. Arthritis Rheum 61:459–467

    Article  PubMed  Google Scholar 

  19. Tompkins M, Arendt EA (2012) Complications in patellofemoral surgery. Sports Med Arthrosc 20:187–193

    Article  PubMed  Google Scholar 

  20. Walker T, Perkinson B, Mihalko WM (2012) Patellofemoral arthroplasty: the other unicompartmental knee replacement. J Bone Join Surg Am. 94:1712–1720

    Article  Google Scholar 

  21. Yamada K, Healey R, Amiel D, Lotz M, Coutts R (2002) Subchondral bone of human knee joint in aging and osteoarthritis. Osteoarthr Cartil 10:360–369

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors wish to thank Professor Shin Aizawa and Professor Hiroshi Yorifuji for their kind technical assistance with dissection. No founding support existed for this study.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Division of Rehabilitation Medicine, Gunma University Hospital, Showa-machi 3-39-15, Maebashi City, Gunma, Japan

    Takanori Iriuchishima

  2. Department of Orthopaedic Surgery, Surugadai Nihon University Hospital, Tokyo, Japan

    Keinosuke Ryu

  3. Department of Functional Morphology, Nihon University School of Medicine, Tokyo, Japan

    Shin Aizawa

  4. Department of Anatomy, Gunma University Graduate School of Medicine, Gunma, Japan

    Hiroshi Yorifuji

Authors
  1. Takanori Iriuchishima
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  2. Keinosuke Ryu
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  3. Shin Aizawa
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  4. Hiroshi Yorifuji
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Correspondence to Takanori Iriuchishima.

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Iriuchishima, T., Ryu, K., Aizawa, S. et al. Cadaveric assessment of osteoarthritic changes in the patello-femoral joint: evaluation of 203 knees. Knee Surg Sports Traumatol Arthrosc 21, 2172–2176 (2013). https://doi.org/10.1007/s00167-012-2308-8

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  • DOI: https://doi.org/10.1007/s00167-012-2308-8

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