In persons with knee OA, knee pain severity was associated with subarticular bone attrition, bone marrow lesions, synovitis/effusion, and meniscal tears. The contribution of bone marrow lesions to pain severity appeared to require the presence of bone attrition.

Objective. To test the hypotheses that lateral patellofemoral (PF) osteoarthritis (OA) progression is more common than medial PF OA progression, that varus alignment increases the likelihood of medial PF OA progression, and that valgus alignment increases the likelihood of lateral PF OA progression.Methods. Patients with knee OA were recruited from the community. Inclusion criteria were definite osteophyte presence (i.e., Kellgren/Lawrence radiographic grade >2) in 1 or both knees and at least some difficulty with knee-requiring activity. Varus-valgus alignment (the angle formed by the intersection of the mechanical axes of the femur and tibia) was measured on a full-limb radiograph at baseline. To assess PF OA progression, weight-bearing skyline views of the PF compartment were obtained at baseline and at 18-month followup. Knees with the highest grade of PF narrowing at baseline were excluded from analysis. Logistic regression and generalized estimating equations were used; odds ratios (ORs) were adjusted for age, sex, and body mass index.Results. Lateral PF OA progression, which occurred in 120 (30%) of 397 knees, was more common than was medial PF OA progression, which occurred in 60 knees (15%). Varus (versus nonvarus) alignment increased the odds of PF OA progression isolated to the medial PF compartment (adjusted OR 1.85, 95% confidence interval [95% CI] 1.00-3.44). Valgus alignment increased the odds of PF OA progression isolated to the lateral compartment (adjusted OR 1.64, 95% CI 1.01-2.66).Conclusion. Lateral PF OA progression was more common than medial progression, and varus-valgus alignment influenced the likelihood of PF OA progression in a compartment-specific manner. Interventions that address the stress imposed by alignment on the PF compartments may delay PF OA progression and should be developed.Knee osteoarthritis (OA) is responsible for a substantial portion of the disability attributable to OA as a whole. Its prevalence increases dramatically with age. Knee OA is a leading cause of disability in older individuals (1); its impact is likely to increase, given the doubling of the population of individuals ages 65 years or older that is expected to occur in the next 30 years.Patellofemoral (PF) involvement in knee OA is relatively frequent and is associated with function limitation at least comparable with and perhaps exceeding the limitation associated with tibiofemoral OA (2). Despite this, natural history studies continue to emphasize the tibiofemoral compartments. Neither the natural history of PF OA nor risk factors for PF OA radiographic progression have been characterized. Knowledge of these factors will allow identification of the individuals in whom OA is most likely to worsen, and will support development of interventions to delay progression.Patellofemoral pathology (e.g., dislocation, lateral pressure syndrome) is more common on the lateral side of the PF joint, due to a lateral reaction force vector (3). The relatively lateral position of the tibial tubercle in full-knee extension...

Objective. To test the hypotheses that 1) osteoarthritic (OA) knees at more advanced stages have less anteroposterior (AP) laxity compared with OA knees at milder stages, 2) AP laxity decreases over time, and 3) the absence of a decrease in AP laxity is associated with greater progression of medial tibiofemoral OA.Methods. The study group comprised 230 patients with knee OA (75% women, mean age 64 years, mean body mass index [BMI] 30 kg/m 2 ). At baseline and 18 months, AP laxity was measured (in millimeters of tibial translation, under AP shear loading), and semiflexed AP knee radiographs (with knee position confirmed by fluoroscopy) were obtained. Osteophytes were graded for each compartment, using a scale of 0-4. Disease progression was measured as the amount of medial joint space loss between baseline and followup, using linear regression with generalized estimating equations.Results. At baseline, measurements of AP laxity were lower in knees with a Kellgren/Lawrence (K/L) score of 4 (mean ؎ SD 5.0 ؎ 2.1 mm) than in those with a K/L score of 0-1 (mean ؎ SD 7.1 ؎ 2.6 mm). There was a weak negative correlation between osteophyte grade and AP laxity. In knees with a K/L score of 0-2, AP laxity was slightly lower at 18 months than at baseline. AP laxity at baseline was not a predictor of progression of OA. Knees without a decrease in AP laxity had a greater loss of medial joint space (0.22 mm greater, after adjusting for age, sex, and BMI) than did knees in which laxity decreased.Conclusion. AP laxity at baseline is not predictive of progression of OA. Although knees with a K/L score of 4 had less AP laxity than those with a K/L score of 0-1, most of this difference was attributable to the significant difference in AP laxity between knees with a K/L score of 0-1 and knees with a K/L score of 2 (i.e., definite osteophytes). Knees in which AP laxity decreased had less medial joint space loss than did knees without a decrease in AP laxity. The knee joint may successfully compensate for AP laxity; the absence of such compensation may have a deleterious effect.

SLE patients had high DMFT and IDCI scores that were associated with a decrease in salivary flow, pH, and buffer capacity. There were high counts of S. sobrinus and S. mutans species, and IDCI is a useful tool to provide more detail about dental caries in epidemiological studies.