What is the relationship between patellofemoral joint osteoarthritis and arthritis in other knee compartments?

Updated: Dec 11, 2019
  • Author: Dinesh Patel, MD, FACS; Chief Editor: Thomas M DeBerardino, MD  more...
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Answer

Osteoarthritis of the patellofemoral joint should be considered as an entity separate from disease in the medial and lateral tibiofemoral compartments of the knee. Not all patients with patellofemoral arthritis have osteoarthritis in the other compartments; arthritis may develop at different times and with different etiologies in the different compartments of the knee.

Some studies have indicated that risk factors for the development of patellofemoral arthritis include increasing body weight, high-intensity running or weight lifting, prior knee injury, and prior patellar dislocation or subluxation.

Kujula and colleagues conducted a longitudinal study to address the mechanical factors leading to arthritis of the patellofemoral joint [15] and found that of those with radiographic evidence of patellofemoral arthritis, 70% had changes to the lateral side of the patella. In this subset of patients, the likelihood of a varus knee alignment was significantly increased compared with those with medial patellofemoral arthritis, who were more likely to have a valgus knee. A total of 292 patients with osteoarthritic knees were evaluated radiographically.

In one third of the patients with patellofemoral arthritis, no radiographic evidence of osteoarthritis was present in other compartments of the knee. This isolated patellofemoral arthritis was seen more often in a valgus alignment than was isolated tibiofemoral arthritis.

In another study, computed tomography of 40 knees in flexion revealed that in patients with patellofemoral arthritis, the tibial tubercle had a significantly more lateral position than it does in normal knees. [16] However, whether this finding represents a cause or a result of arthritic damage to the joint was not determined.


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