Higher BMI may lead to increased patellofemoral compartment wear
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Published results showed higher BMI may be associated with increased cartilage wear in the patellofemoral compartment compared with the tibiofemoral compartment.
Using data from the Osteoarthritis Initiative, Jerry Y. Du, MD, and colleagues stratified 2,006 patients with left or right knee MRIs into four BMI cohorts. Researchers assessed MRI of the knee with the MRI osteoarthritis knee score, and compared patellofemoral, medial and lateral compartment cartilage scores among BMI cohorts, controlling for confounders using linear regression models.
Results showed an independent association between increasing BMI with increasing grades of patellofemoral wear for both right and left knees in the lateral patella facet, medial femoral trochlea and lateral femoral trochlea. Researchers found an association between increasing BMI with medial compartment wear in the posterior femoral area and lateral compartment wear in the central tibial area of the right knee. Increasing BMI was also associated with medial compartment wear in the central femoral area of the left knee, according to results.
“Obesity may preferentially wear out the patellofemoral joint, which has unique implications in patients’ pain and functional abilities,” Du told Healio Orthopedics. “Surgeons should consider altering treatment strategies, such as directed physical therapy and weight loss programs, that avoid patellofemoral stress in obese patients in order to avoid potentially exacerbating pain and accelerating cartilage wear in the patellofemoral joint.”
Perspective
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Obesity rates in the United States continue to increase at a staggering rate. Over the last 2 decades, the prevalence has increased from 30% to 42%, with rates of severe obesity nearly doubling during the same time. Effects of obesity upon the development of OA continue to be investigated with both mechanical and metabolic causes likely contributing to the increased risk of developing OA. Understanding of knee wear patterns in relation to obesity may allow for the development of improved physical therapy programs to target mechanical overload of the patellofemoral joint. As to whether these increasing wear patterns seen in the patellofemoral relative to the tibiofemoral compartments ultimately translates into patient perceived differences in pain, however, remains to be seen.
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