Which patellofemoral joint imaging features are associated with patellofemoral pain? Systematic review and meta-analysis

Drew, Benjamin, Redmond, Anthony, Smith, Toby ORCID: https://orcid.org/0000-0003-1673-2954, Penny, Florence and Conaghan, Philip (2016) Which patellofemoral joint imaging features are associated with patellofemoral pain? Systematic review and meta-analysis. Osteoarthritis and Cartilage, 24 (2). 224–236. ISSN 1063-4584

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Abstract

Objectives: To review the association between patellofemoral joint (PFJ) imaging features and patellofemoral pain (PFP). Design: A systematic review of the literature from AMED, CiNAHL, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PEDro, EMBASE and SPORTDiscus was undertaken from their inception to September 2014. Studies were eligible if they used magnetic resonance imaging (MRI), computed tomography (CT), ultrasound (US) or x-ray (XR) to compare PFJ features between a PFP group and an asymptomatic control group in people < 45 years of age. A pooled meta-analysis was conducted and data was interpreted using a best evidence synthesis. Results: Forty studies (all moderate to high quality) describing 1,043 people with PFP and 839 controls were included. Two features were deemed to have a large standardised mean difference (SMD) based on meta-analysis: an increased MRI bisect offset at 0° knee flexion under load (0.99; 95% CI: 0.49, 1.49) and an increased CT congruence angle at 15° knee flexion, both under load (1.40 95% CI: 0.04, 2.76) and without load (1.24; 95% CI: 0.37,2.12). A medium SMD was identified for MRI patella tilt and patellofemoral contact area. Limited evidence was found to support the association of other imaging features with PFP. A sensitivity analysis showed an increase in the SMD for patella bisect offset at 0° knee flexion (1.91; 95% CI: 1.31,2.52) and patella tilt at 0° knee flexion (0.99; 95% CI: 0.47,1.52) under full weight bearing. Conclusion: Certain PFJ imaging features were associated with PFP. Future interventional strategies may be targeted at these features.

Item Type:	Article
Additional Information:	Open access under a CC BY NC ND licence
Uncontrolled Keywords:	patellofemoral pain,magnetic resonance ima,systematic,diagnostic imaging
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Rehabilitation Faculty of Medicine and Health Sciences > Research Groups > Health Promotion Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User:	Pure Connector
Date Deposited:	03 Nov 2015 15:02
Last Modified:	19 Oct 2023 01:29
URI:	https://ueaeprints.uea.ac.uk/id/eprint/54991
DOI:	10.1016/j.joca.2015.09.004

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