TY - JOUR
T1 - Lateral patellar tilt and its longitudinal association with patellofemoral osteoarthritis-related structural damage
T2 - Analysis of the osteoarthritis initiative data
AU - Zikria, Bashir
AU - Rinaldi, Joseph
AU - Guermazi, Ali
AU - Haj-Mirzaian, Arya
AU - Pishgar, Farhad
AU - Roemer, Frank W.
AU - Hakky, Michael
AU - Sereni, Christopher
AU - Demehri, Shadpour
N1 - Funding Information:
The OAI is a collaborative project between public and private sectors and includes five contracts N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. It is conducted by the OAI investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer, Inc. In preparing this manuscript, OAI publicly-available datasets were used, and the results of this work do not necessarily reflect the opinions of the OAI investigators, the NIH, or the private funding partners. Outside of this work, BZ received honoraria, hospitality payment nonconsulting, and consulting fees from Vericel. Outside of this work, AG received funding for consultation from MerckSerono, AstraZeneca, Genzyme, OrthoTrophix, and TissueGene; and as a shareholder and the president and from Boston Imaging Core Lab (BICL). Outside of this work, FWR received funding from BICL as a shareholder and chief executive officer (CEO). Outside of this work, SD received funding from Toshiba Medical Systems for consultation; and grants for a cone-beam computed tomographic clinical trial from GERRAF, and Carestream Health. None of the authors had any competing interests that could influence the results of this work. All authors participated in the study design, interpretation of results, and drafting the manuscript or critically revising it for important intellectual content. The authors state that this work has not received any funding. Subjects have given informed consent before participating in the OAI. The medical ethics review boards of the University of California, San Francisco (Approval Number: 10-00532), and the four OAI clinical centers recognized the project as Health Insurance Portability and Accountability Act (HIPAA)-compliant.
Funding Information:
The OAI is a collaborative project between public and private sectors and includes five contracts N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. It is conducted by the OAI investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer, Inc. In preparing this manuscript, OAI publicly-available datasets were used, and the results of this work do not necessarily reflect the opinions of the OAI investigators, the NIH, or the private funding partners.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/12
Y1 - 2020/12
N2 - Background: Increase in lateral patellar tilt-(LPT) can cause increased pressure on the lateral facet of the knee and can lead to patellar or femoral cartilage damage and further osseous changes. This study aims to test the hypothesis whether there is an association between increased LPT and MRI-based patellofemoral osteoarthritis-(OA) features at baseline and their worsening over a 2-year follow-up in participants of the Osteoarthritis Initiative-(OAI). Methods: Recorded clinical and imaging data of 600 participants in the FNIH-OA biomarkers consortium was extracted from its database. The LPT-(as the angle between the longest patella diameter and posterior aspect of condyles) was measured using the axial knee MRI. Associations of LPT (every 5° increase) with MRI OA Knee Scoring-(MOAKS) for OA-related features, including cartilage and bone marrow lesions (BMLs) in addition to knee cartilage volume at baseline and their worsening after 2-year follow-up were assessed using regression models adjusted for several possible confounders. Results: The mean LPT angle in this sample was 8.84° ± 5.19. In baseline, higher LPT was associated with lower cartilage volumes and higher cartilage lesions and BMLs MOAKS scores in the lateral trochlear and patellar subregions. Over the follow-ups, subjects with higher LPT measures in the baseline showed higher odds of experiencing BML score worsening in the lateral trochlear subregion-(OR:1.25[1.01–1.56]) over the 2-year follow-ups. Conclusions: Increase in LPT measures may be associated with OA-related features in the trochlear subregion. Therefore, aside from its use as an indicator of patellofemoral instability syndrome, LPT may be associated with longitudinal progression of patellofemoral OA.
AB - Background: Increase in lateral patellar tilt-(LPT) can cause increased pressure on the lateral facet of the knee and can lead to patellar or femoral cartilage damage and further osseous changes. This study aims to test the hypothesis whether there is an association between increased LPT and MRI-based patellofemoral osteoarthritis-(OA) features at baseline and their worsening over a 2-year follow-up in participants of the Osteoarthritis Initiative-(OAI). Methods: Recorded clinical and imaging data of 600 participants in the FNIH-OA biomarkers consortium was extracted from its database. The LPT-(as the angle between the longest patella diameter and posterior aspect of condyles) was measured using the axial knee MRI. Associations of LPT (every 5° increase) with MRI OA Knee Scoring-(MOAKS) for OA-related features, including cartilage and bone marrow lesions (BMLs) in addition to knee cartilage volume at baseline and their worsening after 2-year follow-up were assessed using regression models adjusted for several possible confounders. Results: The mean LPT angle in this sample was 8.84° ± 5.19. In baseline, higher LPT was associated with lower cartilage volumes and higher cartilage lesions and BMLs MOAKS scores in the lateral trochlear and patellar subregions. Over the follow-ups, subjects with higher LPT measures in the baseline showed higher odds of experiencing BML score worsening in the lateral trochlear subregion-(OR:1.25[1.01–1.56]) over the 2-year follow-ups. Conclusions: Increase in LPT measures may be associated with OA-related features in the trochlear subregion. Therefore, aside from its use as an indicator of patellofemoral instability syndrome, LPT may be associated with longitudinal progression of patellofemoral OA.
KW - Lateral patella tilt
KW - Magnetic resonance imaging
KW - Osteoarthritis
KW - Patellofemoral
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U2 - 10.1016/j.knee.2020.11.002
DO - 10.1016/j.knee.2020.11.002
M3 - Article
C2 - 33248351
AN - SCOPUS:85096648960
SN - 0968-0160
VL - 27
SP - 1971
EP - 1979
JO - Knee
JF - Knee
IS - 6
ER -