Cadaveric assessment of osteoarthritic changes in the patello-femoral joint: evaluation of 203 knees
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KNEE
Cadaveric assessment of osteoarthritic changes in the patellofemoral joint: evaluation of 203 knees Takanori Iriuchishima • Keinosuke Ryu Shin Aizawa • Hiroshi Yorifuji
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Received: 9 May 2012 / Accepted: 19 November 2012 Ó Springer-Verlag Berlin Heidelberg 2012
Abstract Purpose The purpose of this study was to determine the prevalence, type of lesion, and depth of osteoarthritic (OA) changes in the patello-femoral (PF) joint. Methods Two hundred and three cadaveric knees were included in this study with median age of 84 years (54–97). Patella OA lesions were classified using Han’s method: (Type 1) no or minimal lesion, (Type 2) medial facet lesion without involvement of the ridge, (Type 3) lateral facet lesion without involvement of the ridge, (Type 4) lesion involvement of the ridge, (Type 5) medial facet lesion with involvement of the ridge, (Type 6) lateral facet lesion with involvement of the ridge, (Type 7) global lesion. Femoral side OA lesions in the PF joint were classified using modified Chang’s method: (Type 1) no or minimal lesion, (Type 2) medial facet lesion, (Type 3) centre of patella groove lesion, (Type 4) lateral facet lesion, (Type 5) global lesion. OA depth evaluation was performed following Outerbridge’s classification.
T. Iriuchishima (&) Department of Rehabilitation Medicine, Division of Rehabilitation Medicine, Gunma University Hospital, Showa-machi 3-39-15, Maebashi City, Gunma, Japan e-mail: [email protected] K. Ryu Department of Orthopaedic Surgery, Surugadai Nihon University Hospital, Tokyo, Japan S. Aizawa Department of Functional Morphology, Nihon University School of Medicine, Tokyo, Japan H. Yorifuji Department of Anatomy, Gunma University Graduate School of Medicine, Gunma, Japan
Results OA lesions of the patella were observed as follows: (Type 1) 31 %, (Type 2) 16 %, (Type 3) 3 %, (Type 4) 12 %, (Type 5) 22 %, (Type 6) 2 %, (Type 7) 14 %. Outerbridge’s classification of over Grade 2 OA depth was observed in 75.9 % of subjects. Femoral side OA lesions of the PF joint were observed as follows: (Type 1) 42 %, (Type 2) 20 %, (Type 3) 26 %, (Type 4) 2 %, (Type 5) 11 %. Outerbridge’s classification of over Grade 2 OA depth was observed in 58 % of subjects. Conclusion Patella OA and femoral side OA in the PF joint occurred mainly on the medial side. Isolated OA in the lateral facet of the PF joint was exceedingly rare. Female subjects had a greater incidence of severe PF-OA than male subjects, and therefore, the physicians should pay attention when they treat the female subjects not to advance the PF-OA. Keywords Knee
Osteoarthritis Patella Patello-femoral joint
Abbreviations OA Osteoarthritis PF Patello-femoral
Introduction As with tibio-femoral joint osteoarthritic (OA) change, patello-femoral (PF) OA is one of the most severe causes of knee pain in the elderly population [11]. Once PF-OA occurs, patients develop anterior knee pain, and sometimes have difficulty using stairs or bending the knees at deep flexion angles [11]. It is believed that the causes of PF-
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