Ukachukwu, V, Duncan, R, Belcher, J, Marshall, M, Stefanik, J, Crossley, K, Thomas, M and Peat, GM ORCID: 0000-0002-9008-0184 (2016) Clinical significance of medial vs lateral compartment patellofemoral osteoarthritis: cross-sectional analyses in an adult population with knee pain. Arthritis Care and Research, 69 (7). pp. 943-951. ISSN 2151-4658

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J Belcher - Clinical significance of medial vs lateral compartment patellofemoral osteoarthritis - cross-sectional analyses in an adult population with knee pain.pdf - Accepted Version
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Abstract

Objective
To determine the comparative prevalence, associations with selected patient characteristics, and clinical outcomes of medial and lateral compartment patellofemoral (PF) joint osteoarthritis (OA).

Methods
Information was collected by questionnaires, clinical assessment, and radiographs from 745 eligible community‐dwelling symptomatic adults age ≥50 years. PF joint space narrowing (JSN) and osteophytes were scored from skyline radiographs using the Osteoarthritis Research Society International atlas. Multilevel models were used to assess associations of compartmental PF joint OA with age, sex, body mass index (BMI) and varus–valgus malalignment, while median regression was used to examine associations with clinical outcomes (current pain intensity on a numeric rating scale [0–10] and the function subscale of the Western Ontario and McMaster Universities Osteoarthritis Index [0–68]).

Results
Isolated lateral PF joint OA was more common than isolated medial PF joint OA, particularly at higher severity thresholds. Irrespective of severity threshold, age (≥2 odds ratio [OR] 1.19 [95% confidence interval (95% CI) 1.12, 1.26]), BMI (≥2 OR 1.15 [95% CI 1.07, 1.24]), and valgus malalignment (≥2 OR 2.58 [95% CI 1.09, 6.07]) were associated with increased odds of isolated lateral JSN, but isolated medial JSN was only associated with age (≥2 OR 1.20 [95% CI 1.14, 1.27]). The pattern of association was less clear for PF joint osteophytes. Isolated lateral PF joint OA, defined by JSN or osteophytes, was associated with higher pain scores than isolated medial PF joint OA, but these differences were modest and were not significant. A similar pattern of association was seen for functional limitation but only when PF joint OA was defined by JSN.

Conclusion
Isolated lateral PF joint OA is more common than isolated medial PF joint OA, and it is more consistently associated with established OA risk factors. It is also associated with higher, but clinically nonsignificant, pain and function scores than isolated medial PF joint OA, particularly when PF joint OA is defined using JSN.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Wiley at https://doi.org/10.1002/acr.23110 Please refer to any applicable terms of use of the publisher.
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 11 Oct 2016 15:34
Last Modified: 21 Aug 2018 15:11
URI: http://eprints.keele.ac.uk/id/eprint/2270

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