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Infrapatellar fat pad volume is greater in individuals with patellofemoral joint osteoarthritis and associated with pain

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Abstract

There is relatively little research specifically investigating patellofemoral joint osteoarthritis (PFJ OA). In particular, the source of pain in PFJ OA has not been established. One structure that may be an important contributor is the infrapatellar fat pad (IPFP). This cross-sectional study aimed to: (1) compare IPFP volume in individuals with and without PFJ OA and (2) assess the relationship between IPFP volume and pain in individuals with PFJ OA. Thirty-five participants with symptomatic and radiographic PFJ OA and 11 asymptomatic controls with no radiographic signs of OA were recruited. IPFP volume was measured in both groups from magnetic resonance images, and pain in the PFJ OA group was determined using the pain subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS-pain). The PFJ OA group had 23.6 % greater IPFP volume than the control group (p = 0.04). After the inclusion of covariates, IPFP volume remained 19.6 % greater in the PFJ OA group (p = 0.03). IPFP volume explained 20.1 % of the variance in KOOS-pain in the PFJ OA group, with a larger IPFP being associated with worse pain (p < 0.01). Individuals with PFJ OA had a larger IPFP than controls, and IPFP volume was directly related to PFJ OA pain. These data suggest a role for the IPFP in PFJ OA and highlight a need for further investigation into the casual relationship between IPFP and PFJ changes.

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References

  1. Hinman RS, Crossley KM (2007) Patellofemoral joint osteoarthritis: an important subgroup of knee osteoarthritis. Rheumatology 46:1057–1062

    Article  CAS  PubMed  Google Scholar 

  2. Duncan RC, Hay EM, Saklatvala J, Croft PR (2006) Prevalence of radiographic osteoarthritis: it all depends on your point of view. Rheumatology 45:757–760

    Article  CAS  PubMed  Google Scholar 

  3. Hinman RS, Lentzos J, Vicenzino B, Crossley KM (2014) Is patellofemoral osteoarthritis common in middle-aged people with chronic patellofemoral pain? Arthritis Care Res 66:1252–1257

    Article  Google Scholar 

  4. Kornaat PR, Bloem JL, Ceulemans RY, Riyazi N, Rosendaal FR, Nelissen RG et al (2006) Osteoarthritis of the knee: association between clinical features and MR imaging findings. Radiology 239:811–817

    Article  PubMed  Google Scholar 

  5. Mazzuca SA, Brandt KD, Katz BP, Ding Y, Lane KA, Buckwalter KA (2006) Risk factors for progression of tibiofemoral osteoarthritis: an analysis based on fluoroscopically standardised knee radiography. Ann Rheum Dis 65:515–519

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Clockaerts S, Bastiaansen-Jenniskens YM, Runhaar J, Van Osch GJ, Van Offel JF, Verhaar JA et al (2010) The infrapatellar fat pad should be considered as an active osteoarthritic joint tissue: a narrative review. Osteoarthr Cartil. 18:876–882

    Article  CAS  PubMed  Google Scholar 

  7. Culvenor AG, Cook JL, Warden SJ, Crossley KM (2011) Infrapatellar fat pad size, but not patellar alignment, is associated with patellar tendinopathy. Scand J Med Sci Sports 21:e405–e411

    Article  CAS  PubMed  Google Scholar 

  8. Dragoo JL, Johnson C, McConnell J (2012) Evaluation and treatment of disorders of the infrapatellar fat pad. Sports Med 42:51–67

    Article  PubMed  Google Scholar 

  9. Ioan-Facsinay A, Kloppenburg M (2013) An emerging player in knee osteoarthritis: the infrapatellar fat pad. Arthritis Res Ther. 15:225

    Article  PubMed Central  PubMed  Google Scholar 

  10. Crossley KM, Vicenzino B, Pandy MG, Schache AG, Hinman RS (2008) Targeted physiotherapy for patellofemoral joint osteoarthritis: a protocol for a randomised, single-blind controlled trial. BMC Musculoskelet Disord. 9:122

    Article  PubMed Central  PubMed  Google Scholar 

  11. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96

    Article  CAS  PubMed  Google Scholar 

  13. Ballegaard C, Riis RG, Bliddal H, Christensen R, Henriksen M, Bartels EM et al (2014) Knee pain and inflammation in the infrapatellar fat pad estimated by conventional and dynamic contrast-enhanced magnetic resonance imaging in obese patients with osteoarthritis: a cross-sectional study. Osteoarthr Cartil. 22:933–940

    Article  CAS  PubMed  Google Scholar 

  14. Chuckpaiwong B, Charles HC, Kraus VB, Guilak F, Nunley JA (2010) Age-associated increases in the size of the infrapatellar fat pad in knee osteoarthritis as measured by 3T MRI. J Orthop Res 28:1149–1154

    Article  PubMed Central  PubMed  Google Scholar 

  15. Han W, Cai S, Liu Z, Jin X, Wang X, Antony B et al (2014) Infrapatellar fat pad in the knee: is local fat good or bad for knee osteoarthritis? Arthritis Res Ther 16:R145

    Article  PubMed Central  PubMed  Google Scholar 

  16. Pan F, Han W, Wang X, Liu Z, Jin X, Antony B et al (2014) A longitudinal study of the association between infrapatellar fat pad maximal area and changes in knee symptoms and structure in older adults. Ann Rheum Dis. doi:10.1136/annrheumdis-2013-205108

  17. Dye SF, Vaupel GL, Dye CC (1998) Conscious neurosensory mapping of the internal structures of the human knee without intraarticular anesthesia. Am J Sports Med 26:773–777

    CAS  PubMed  Google Scholar 

  18. Hinman RS, Crossley KM, McConnell J, Bennell KL (2003) Efficacy of knee tape in the management of osteoarthritis of the knee: blinded randomised controlled trial. BMJ 327:135

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The project was funded by the National Health and Medical Research Council Project Grant (#508966). H.F.H. is supported by a National Health and Medical Research Council (Australia) Post-graduate Scholarship (#813021).

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Physiotherapy, St Vincent’s Hospital, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia

    Sallie M. Cowan

  2. Department of Physiotherapy, The University of Melbourne, Parkville, VIC, Australia

    Sallie M. Cowan & Harvi F. Hart

  3. Department of Mechanical Engineering, The University of Melbourne, Parkville, VIC, Australia

    Harvi F. Hart & Kay M. Crossley

  4. Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA

    Stuart J. Warden

  5. Department of Physiotherapy, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, Australia

    Stuart J. Warden & Kay M. Crossley

Authors
  1. Sallie M. Cowan
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  2. Harvi F. Hart
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  3. Stuart J. Warden
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  4. Kay M. Crossley
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Correspondence to Sallie M. Cowan.

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Cowan, S.M., Hart, H.F., Warden, S.J. et al. Infrapatellar fat pad volume is greater in individuals with patellofemoral joint osteoarthritis and associated with pain. Rheumatol Int 35, 1439–1442 (2015). https://doi.org/10.1007/s00296-015-3250-0

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  • DOI: https://doi.org/10.1007/s00296-015-3250-0

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