Search

BACKGROUND: Structural abnormalities associated with osteoarthritis (OA) are found in some patients with patellofemoral pain (PFP). OBJECTIVES: To investigate the association between early signs of OA on magnetic resonance imaging (MRI) and characteristics from self-reported measures and physical examination in patients with PFP METHODS: This exploratory study included data from patients with PFP from a previously published cross-sectional case-control study (n = 64; 55% female; mean ± SD age, 23.4 ± 7.0 years). Structural OA features (osteophytes, bone marrow lesions, cartilage defects, Hoffa synovitis, patellar tendon abnormalities) and quantitative T2 measurements of cartilage composition were extracted from MRI. Associations between characteristics from self-reported measures (pain at rest, pain during stair walking, knee function, duration of complaints, hours of sports participation each week), physical examination (crepitus, quadriceps strength), and early MRI signs of OA were assessed. RESULTS: Symptom duration was associated with bone marrow lesions in the patella (odds ratio [OR] = 1.1; 95% confidence Interval [Cl]: 1,0,1.2). Sports participation (hours per week) was inversely associated with patellar tendon abnormalities on MRI (OR = 0.8; 95% Cl: 0.6,1.0). Crepitus and bilateral nature of the complaints were associated with minor patellar cartilage defects (OR = 12.0; 95% Cl: 2.3,63.6 and OR = 7.6; 95% Cl: 1.1,53.8, respectively). There were no significant associations between clinical characteristics and cartilage T2 relaxation time. CONCLUSION: Presence of crepitus, bilateral complaints, a long PFP symptom duration, and reduced weekly sport participation were associated with early signs of OA in a young PFP population. LEVEL OF EVIDENCE: Etiology, level 2c. [ABSTRACT FROM AUTHOR]

* STUDY DESIGN: Case series with 1-year follow-up. * BACKGROUND: Most of the recommendations for the diagnosis, treatment, and prognosis of patellofemoral pain (PFP) are based on research performed in adults. The literature suggests that there are potential differences between adolescents and adults with PFP. * OBJECTIVES: To investigate differences in characteristics, symptoms, and prognosis at 1-year follow-up between adolescents and adults with PFP. * METHODS: Data from 64 patients with PFP, assessed at baseline and 1-year follow-up, were used. At baseline, data on demographics, symptoms, and coping strategies were obtained by questionnaire. Physical examination included strength and flexibility measurements of the quadriceps and hamstrings. At 1-year follow-up, a questionnaire was used to collect data on pain, function, and recovery. Differences between adolescents (14-18 years) and adults (18-40 years) were analyzed using regression techniques, adjusted for sex, body mass index, and the presence of bilateral pain. * RESULTS: Of the 64 patients with PFP included at baseline, 78.1% were available for follow-up. At baseline, adolescents with PFP had a significantly lower body mass index (20.7 versus 24.9 kg/hf) and a greater percentage of bilateral pain (70% versus 43.2%) than adults with PFP. There were no differences in reported pain and symptoms between the 2 groups. In total, 25% of the adolescents regarded themselves as recovered after 1 year, compared to 22.7% of the adults (adjusted P = .725). * CONCLUSION: The sample size of the study, in relation to the number of statistical tests performed, urges caution in the interpretation of the results. In contrast to what has been suggested previously, only minor differences seem to exist between adolescents and adults with PFP. In both groups, PFP is clearly not a self-limiting disease, with nearly 75% of those in this study reporting persistent pain at 1-year follow-up. * LEVEL OF EVIDENCE: Prognosis, level 4. [ABSTRACT FROM AUTHOR]