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Association of severity of coexisting patellofemoral disease with increased impairments and functional limitations in patients with knee osteoarthritis . OBJECTIVE To evaluate the association between severity of coexisting patellofemoral ( PF ) disease with lower extremity impairments and functional limitations in patients with tibiofemoral ( TF ) osteoarthritis ( OA ) . METHODS Radiographic views of the TF and PF compartments , knee extension strength , and knee range of motion were obtained for 167 patients with knee OA . Additionally , knee-specific symptoms and functional limitations were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) and the Activities of Daily Living Scale ( ADLS ) . RESULTS Moderate/severe PFOA was associated with lower knee extension strength ( mean ± SD 1.4 ± 0.5 Nm/body weight [ BW ] ) compared to no PFOA ( mean ± SD 1.8 ± 0.5 Nm/BW ) . Additionally , total knee range of motion was significantly lower for patients with moderate/severe PFOA ( mean ± SD 120.8° ± 14.4° ) compared to no PFOA ( mean ± SD 133.5° ± 10.7° ) and mild PFOA ( mean ± SD 125.8° ± 13.0° ) . Moderate/severe PFOA and mild PFOA were also associated with less pain while standing ( odds ratio [ OR ] 0.2 , 95 % confidence interval [ 95 % CI ] 0.1-0.7 and OR 0.2 , 95 % CI 0.1-0.6 , respectively ) on the WOMAC , and moderate/severe PFOA was associated with greater difficulty with going downstairs ( OR 2.9 , 95 % CI 1.0-8.1 ) on the ADLS . CONCLUSION It appears that knees with more severe coexisting PF disease demonstrate features distinct from those observed in TFOA in isolation or in combination with mild PF disease . Treatment strategies targeting the PF joint may be warranted to mitigate the specific lower extremity impairments and functional problems present in this patient population .
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Radiographic views
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knee extension strength
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knee range of motion
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knee-specific symptoms
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functional limitations
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Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC )
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and the
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Activities of Daily Living Scale ( ADLS )
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knee extension strength