Abstract
BACKGROUND: Patellofemoral joint osteoarthritis is a highly prevalent disease and an important source of pain and disability. Nonetheless, biomechanical risk factors associated with this disease remain unclear. The purpose of this study was to compare biomechanical factors that are associated with patellofemoral joint loading during walking between individuals with isolated patellofemoral joint osteoarthritis and no osteoarthritis. METHODS: MR images of the knee were obtained using a 3D fast-spin echo sequence to identify patellofemoral joint cartilage lesions. Thirty-five subjects with isolated patellofemoral joint osteoarthritis (29 females) and 35 control subjects (21 females) walked at a self-selected speed and as fast as possible. Peak knee flexion moment, flexion moment impulse and peak patellofemoral joint stress during the first and second halves of the stance phase were compared between groups. FINDINGS: When compared to the controls, individuals with patellofemoral joint osteoarthritis demonstrated significantly higher peak knee flexion moment (P=.03, Eta(2)=.07), higher knee flexion moment impulse (P=.03, Eta(2)=.07) and higher peak patellofemoral joint stress (P=.01, Eta(2)=.10) during the second half of the stance phase. No significant group difference was observed during the first half of the stance phase. INTERPRETATION: Findings of this study suggest that increased mechanical loading (i.e. knee flexion moment, impulse and patellofemoral joint stress) during the second half of the stance phase is associated with patellofemoral joint osteoarthritis. Prevention and rehabilitation programs for patellofemoral joint osteoarthritis may focus on reducing the loading on the patellofemoral joint, specifically during late stance.