Does medial patellofemoral osteoarthritis matter? the relation of mri-detected structural damage in the medial and lateral patellofemoral joint to knee pain: the most and framingham osteoarthritis studies

Abstract

s / Osteoarthritis and Cartilage 22 (2014) S7–S56 S54 groups (DEP þ GS, DEP þ placebo, DEP control þ GS) were compared separately with the DEP control þ placebo group as reference group. Results: 687 knees of 347 women with mean age 55.7 years ( 3.2 SD) and mean BMI 32.3kg/m2 ( 4.2 SD) had baseline and follow-up MRI available for analysis. There was no selective drop-out and the women were equally distributed over the 4 groups. ITT analysis showed a significant preventive effect in the DEP þ placebo group on overall progression of meniscus pathology (OR 0.61, 95% CI [0.38 0.99], p-value (p) 0.046). PP analysis showed a significant preventive effect in the DEP þ placebo group on overall progression of meniscus pathology (OR 0.43, 95% CI [0.22 0.84], p 0.014) and on overall progression of bone marrow lesions (OR 0.26, 95% CI [0.08 0.88], p 0.030). The 2 other groups (DEP þGS and DEP controlþGS) showed no significant effects on overall MRI OA-features. When differentiated according to location in the knee, all effects were seen in the medial meniscus or at the medial tibio-femoral compartment. (ITT: medial meniscus extrusion: OR 0.47, 95% CI [0.24 0.91], p 0.025; medial bone marrow lesion: OR 0.33, 95% CI [0.14 -0.77], p 0.011, PP: medial bone marrow lesion: OR 0.13, 95% CI [0.02 0.93], p 0.042). Evaluating the effects of the MRI OA-features on pain, 42 of 347 women (12%) met the definition of incident chronic knee pain in one or both knees (52 of 687 knees (6.7%)). Progression of bonemarrow lesions was significant associated with incident chronic knee pain (OR 2.1, 95% CI [1.02 4.46]). Conclusions: A diet and exercise program has preventive effects on progression of meniscus pathology and on bonemarrow lesions seen on MRI. Progression of bone marrow lesions is associated with incident chronic knee pain. 82 DOES MEDIAL PATELLOFEMORAL OSTEOARTHRITIS MATTER? THE RELATION OF MRI-DETECTED STRUCTURAL DAMAGE IN THE MEDIAL AND LATERAL PATELLOFEMORAL JOINT TO KNEE PAIN: THE MOST AND FRAMINGHAM OSTEOARTHRITIS STUDIES J. Stefanik y, K. Gross z, D. Felson y, J. Niu y, Y. Zhang y, C. Lewis x, N. Segal k, M. Nevitt{, F. Roemer#, A. Guermazi y, T. Neogi y. yBoston Univ., Boston, MA, USA; zMGH Inst. of Hlth.Professions, Boston, MA, USA; xUniv. of Alabama, Birmingham, AL, USA; kUniv. of Iowa, Iowa City, IA, USA; {UCSF, San Francisco, CA, USA; Klinikum Augsburg, Augsburg, Germany Purpose: Contrary to the expectations of biomechanical models, we previously demonstrated a high prevalence of MRI detected cartilage