Bashir Zikria1, Joseph Rinaldi2, Ali Guermazi3, Arya Haj-Mirzaian4, Farhad Pishgar4, Frank W Roemer5, Michael Hakky6, Christopher Sereni7, Shadpour Demehri4. 1. Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA. Electronic address: bzikria2@jhmi.edu. 2. Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA. 3. Department of Radiology, Boston University School of Medicine, Boston, MA, USA. 4. Russell H. Morgan Department of Radiology, Johns Hopkins University, Baltimore, MD, USA. 5. Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg & Universitätsklinikum Erlangen, Erlangen, Germany. 6. Department of Radiology, Florida Hospital, Maitland, FL, USA. 7. Department of Radiology, University of Massachusetts Medical School, Boston, MA, USA.
Abstract
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 betweenthe longest patella diameter and posterior aspect of condyles) was measured using theaxial 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.
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 betweenthe longest patella diameter and posterior aspect of condyles) was measured using theaxial 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.
Authors: Paula Giesler; Frederic A Baumann; Dominik Weidlich; Dimitrios C Karampinos; Matthias Jung; Christian Holwein; Julia Schneider; Alexandra S Gersing; Andreas B Imhoff; Fabian Bamberg; Pia M Jungmann Journal: Skeletal Radiol Date: 2021-07-04 Impact factor: 2.199