A multi-center study investigated the correlation between the severity of knee tibiofemoral osteoarthritis and the alignment of patellofemoral and patellar height on radiographs

Abstract

AbstractBackground：It remains uncertain if there is a correlation between the morphological structure of the patellofemoral joint (PFJ) and the severity of tibiofemoral osteoarthritis (TFOA) in the knee.Objective：The objective of this research was to establish the correlation between the severity of knee TFOA on radiographs and either patellar height or patellofemoral alignment.Methods:We retrospectively analyzed the MRI scans and anteroposterior radiographs of 534 TFOA patients. To evaluate the radiographic severity of TFOA, the anteroposterior radiographs of the knee and the Kellgren-Lawrence (K-L) grade were utilized. Knee MRI scans were used to measure the patellar length ratio (PLR), sulcus angle (SA), lateral patella tilt angle (LPTA), and the distance between the tibial tuberosity and trochlear groove (TT-TG). An examination was conducted on the association among the configuration of PFJ, arrangement, and the harshness of TFOA. Information on the participants' demographics, such as their age, gender, body asymmetry, height, and weight, was gathered. Statistical analysis involved the utilization of Chi-square test, Pearson correlation, and multiple linear regression.The study comprised of 534 patients, with a total of 586 knees. Of these, 339 (63%) were female and 195 (37%) were male. Females were found to have a higher occurrence of arthritis compared to males. No significant correlation was found between the laterality of the body and the severity of TFOA on radiographs. Age (r = 0.647, P < 0.01), LPTA (r = -0.626, P < 0.01), SA (r = 0.534, P < 0.05) and TT-TG (r = 0.697, P < 0.01) were strongly correlated with the severity of TFOA, as indicated by Pearson correlation. The severity of TFOA was found to be associated with age (β = 0.379, P < 0.01), BMI (β = 0.059, P < 0.01), LPTA (β = -0.144, P < 0.01), SA (β = 0.155, P < 0.01), and TT-TG (β = 0.367, P < 0.01) through multiple linear regression analysis.Conclusion:The radiographic severity of TFOA was positively linked to age, body mass index (BMI), SA, and TT-TG, but negatively associated with LPTA. Early intervention strategies for patients at risk of developing TFOA can be provided based on our conclusive findings with significant clinical implications.