Changes in clinical symptoms and functional disability in patients with coexisting patellofemoral and tibiofemoral osteoarthritis: a 1-year prospective cohort study

BMC Musculoskeletal Disorders

Research Article

Shuichi Matsuda¹  Hiroshi Kuroki²  Naoto Fukutani²  Tomoki Aoyama²  Hirotaka Iijima³  Kazuyuki Miyanobu⁴  Masakazu Hiraoka⁴  Eishi Kaneda⁴  Yuko Yamamoto⁴  Masashi Jinnouchi⁴  Takuya Isho⁵ 

[1] Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan;Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan;Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan;Japan Society for the Promotion of Science, Tokyo, Japan;Nozomi Orthopaedic Clinic, Hiroshima, Japan;Rehabilitation Center, Fujioka General Hospital, Gunma, Japan;

关键词: Patellofemoral osteoarthritis;    Tibiofemoral osteoarthritis;    Knee pain;    Disability;   

DOI  :  10.1186/s12891-017-1486-4

 received in 2016-09-27, accepted in 2017-03-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThis 1-year prospective cohort study aimed to compare the changes in clinical symptoms and functional disability between patients with coexisting patellofemoral (PF) and tibiofemoral (TF) osteoarthritis (OA) and those with isolated TFOA.MethodsSeventy-two patients with medial knee OA were enrolled. Knee pain and functional disability were assessed at baseline and at 1-year follow-up using the Japanese Knee Osteoarthritis Measure (JKOM) and a visual analog scale (VAS). We performed two-way analysis of covariance for the clinical outcome variables to examine, time (baseline and follow-up), group (coexisting PFOA and isolated TFOA), and time-group interaction effects. Furthermore, we conducted post-hoc exploratory analysis to address the possibility that dividing patients according to location of PFOA (i.e., isolated lateral, isolated medial, and mixed [bilateral]) may identify a distinct subgroup with different changes in clinical outcomes at 1-year follow-up.ResultsWe detected group effects only in scores of the JKOM pain subscale (P = 0.012) and VAS (P = 0.033), adjusted for age, sex, and body mass index. Patients with coexisting PFOA have stable moderate level knee pain and functional disability throughout the year which is significantly worse than that in those with isolated TFOA. Post-hoc subgroup analysis demonstrated that change of knee pain likely varied with location of PFOA. Patients with isolated lateral PFOA had mild/moderate level knee pain, and their VAS scores were likely to improve, whereas those with mixed PFOA exhibited stable to worsening moderate/severe knee pain.ConclusionsAlthough we did not detect differences in changes in clinical symptoms and functional disability between patients with coexisting PFOA and those with isolated TFOA, our findings indicate that patients with coexisting PFOA had worse clinical symptoms and functional disability than those with isolated TFOA. The results of the exploratory analysis suggested that patients with coexisting PFOA might have heterogeneous clinical outcomes, and presence of mixed PFOA might be an indicator of severe clinical knee OA.

【 授权许可】

CC BY   
© The Author(s). 2017