Objective: To investigate the relation of trochlea morphology and patellofemoral alignment to prevalent radiographic patellofemoral osteoarthritis (PFOA). Design: A within-person knee-matched case-control study was performed. Participants with unilateral radiographic PFOA were selected from the Multicenter Population-based Osteoarthritis Study (MPOA) in three towns in northern China that was approved by Peking University Health Science Center Ethics Committee (2018PHB166-01). Radiographic PFOA, radiographic tibiofemoral OA, sulcus angle, patellofemoral index and patella displacement were assessed using posterio-anterior and skyline views of the knee. We classified sulcus angle, patellofemoral index and patella displacement into quarters and investigated the relation of each of these measures to prevalent radiographic PFOA. Results: Among 451 participants (mean age: 65.2 years, women: 66.8%) with unilateral radiographic PFOA, a reverse J-shaped relationship was observed between sulcus angle and prevalent radiographic PFOA (P ¼ 0.039 for quadratic term). Both higher patellofemoral index and patella displacement were associated with higher prevalent radiographic PFOA. Adjusted odds ratios (ORs) of prevalent radiographic PFOA in the highest quarter of patellofemoral index and patella displacement were 4.69 and 3.60 (P for trend <0.001), respectively, compared with the lowest quarter of each measurement. A similar relationship was observed between sulcus angle with either prevalent radiographic lateral or medial PFOA. Higher values of patellofemoral index and patella displacement were statistically significantly associated with higher prevalent radiographic lateral (ORs ¼ 5.07 and 4.59, respectively), but not medial PFOA (ORs ¼ 0.58 and 0.76, respectively). Conclusion: Extreme sulcus angles as well as higher values of patellofemoral index and patella displacement were associated with higher prevalent radiographic PFOA.

chronic conditions: heart problems, high blood pressure, stroke, diabetes, asthma, osteoarthritis (OA), total hip replacement (THR), total knee replacement (TKR), anxiety, depression, and dementia. Only male participants from the former cricketer and general populations were included in analysis. Standardized mortality ratios (SMRs) and their 95% confidence intervals (CI) were used to compare prevalences of chronic condition outcomes in former cricketers aged 50 and over to a general population sample from the English Longitudinal Study of Ageing (ELSA). Both the former cricketer sample and general population were standardized by gender, age, and BMI for analysis. Results: 113 former elite cricketers were included from the cricketer sample, with a mean age of 65.1 (SD 9.1) and mean BMI of 27.9 (SD 4.0), and 4496 participants were included from the general population sample, with a mean age of 64.2 (SD 9.6) and mean BMI of 27.6 (SD 3.8). The prevalence of heart problems was significantly reduced in the former cricketers compared to the general population (ELSA) with an SMR of 0.55 (CI 0.33-0.91) (see table). OA, THR, and TKR were significantly increased in the former cricketers compared to the general population, with SMRs of 3.64 (CI 2.81-4.71), 3.99 (CI 2.21-7.20), and 3.84 (CI 1.92-7.68), respectively. The SMRs for anxiety and depression were also significantly increased in former cricketers compared to the general population, at 3.95 (CI 2.34-6.67) and 2.22 (CI 1.20-4.14), respectively. Conclusions: Musculoskeletal and mental health outcomes measured in this study were significantly increased in the former cricketers compared to the general population (ELSA). Cardiovascular conditions in the former cricketers were either significantly decreased (heart problems) or not significantly different (high blood pressure, stroke) compared to the general population. This study presents the first data of its kind amongst former elite cricketers, which will be important to enable a balanced assessment of the long-term health impacts of cricket and also to identify strategies to prevent and mitigate negative outcomes for future cricketers.

Conclusions: Increased PI would probably lead to a greater a angle, which suggested that older patients with greater PI might have greater probability for femoral malposition. The distal femur anterior cortex and a angle might be useful index for sagittal alignment of femoral component in TKA. The patients with neutral-to-mild flexion of femoral component(0 a angle flexion3) would possibly gain a good clinical outcome.

secondary outcomes were not significant in any of the models (all pvalues were >0.172). Conclusions: These results showed that baseline medial meniscus and the change of medial meniscus volume over time may indicate the development of structural knee OA. Therefore, meniscal volume might function as a prognostic biomarker for knee OA in the future, which might perform better than qualitatively scored meniscal pathology.Purpose: Patient satisfaction is an important measure of patient-centered outcomes and physician performance. Given the continued growth of the population undergoing surgical intervention for osteoarthritis, and the concomitant growth in the associated direct costs, understanding what factors drive satisfaction in this population is critical. A potentially important driver not previously considered is satisfaction with pre-surgical consultation. We investigated the influence of pre-surgical consultation satisfaction on overall satisfaction following surgery for osteoarthritis. Methods: Study data are from 1263 patients who underwent surgery for hip (n¼480), knee (n¼597), and spine (n¼186) osteoarthritis at a large teaching hospital in Toronto, Canada. Before surgery, patients reported their satisfaction with the information received and the degree of input in decision-making during the pre-surgical consultation, along with expectations of surgery (regarding pain, activity limitation, expected time to full recovery and likelihood of complete success). Preand post-surgery (6 weeks, and 3, 6, and 12 months) patients reported their average pain level in the past week (0-10; 10 is worst). At each follow-up time-point, two pain variables were defined, pain improvement (minimal clinically important difference from baseline 2 points) and 'acceptable' pain (pain score 3). Patients also completed a question on satisfaction with the results of the surgery (very dissatisfied/dissatisfied/somewhat satisfied/very satisfied) at each follow-up time point. We used multilevel ordinal logistic regression to examine the influence of pre-surgery satisfaction with consultation on the trajectory of satisfaction over the year of recovery controlling for expectations of surgery, pain improvement, acceptable pain, sociodemographic factors (age, sex, and education), body mass index, comorbidity, and depressive symptoms (Hospital Anxiety and Depression Scale). Results: The sample mean age was 65.5 years and over half (54.3%) were women. Overall, 74.0% and 78.9% of patients were satisfied with the information received and with the decision-making in the presurgical consultation, respectively; no significant differences were found by surgical joint (p¼0.22). Post-surgery, levels of satisfaction varied very little over time (6 weeks: 92.5% were satisfied and 66.4% were very satisfied; 1 year: 91.1% were satisfied and 65.6% were very satisfied). Results from a model including time, surgical joint, satisfaction with consultation and control factors indicated that being satisfied with the information received in the pre-surgical con...

No abstract

Purpose: The incidence of radiographic patellofemoral osteoarthritis(RPFOA) remains unclear, few studies have reported the prevalence of RPFOA before, no research has performed a prediction model of RPFOA worldwide and few studies have discussed the imaging characteristic of PFOA. This study aims to describe the incidence of RPFOA in a Chinese suburban area, examine the risk factors for RPFOA incidence and establish a prediction model of RPFOAin a populationbased longitudinal study,a simple analysis of CT imaging features of new onset population is made simultaneously. Methods: Shunyi Osteoarthritis Study was a population-based, longitudinal and prospective study of knee osteoarthritis in a Chinese suburban area. 1295 residents aged over 50 years were recruited by randomized cluster sampling with fully informed in 2014 and were followed 3 years later. At the time of baseline and follow-up visits, subjects completed a home interview (including socio-demographic factors, history of knee injury, joint symptoms, job-related physical activity and work history) and received a clinical examination including height, weight, range of motion(ROM), chair stand test, 50 feet walk test, and weight-bearing posterior-anterior semi-flexed view of radiographs at tibiofemoral(TF) joints and skyline view of radiographs at patellofemoral(PF) joints included. We defined a subject as having patellofemoral OA on skyline view when (1) the osteophyte score was 2 ;(2) the JSN score was 2 and the osteophyte score was 1;(3) the JSN score was 3. For each batch of Shunyi PFOA Study films(n¼100), 20 films from the 2014 Shunyi study were added to test inter-reader reliability. In addition, 20 previously read PF radiographs from the 2017 Shunyi study were fed back to test intra-reader reliability. None-weighted Kappa statistics for inter-reader and intra-reader reliability were 0.82 and 0.85 respectively. Multiple logistic regression was used to examine all the factors at baseline to the risk of incident RPFOA. Multivariate logistic regression was used to estimate the coefficients of each risk factors. The continuous variable was cut into groups, the median value of the group was used as a reference value. The distance(D) from the baseline to each risk factor was calculated by multipling the regression coefficient of the age and the group space(10). Set the unit distance B of 1 point, score the Point¼D/B of each risk factor. The probability(P) can be calculated by the logistic probability calculation formula. Results: A total of 1295 participants (2590 knees) were recruited at baseline in 2013, and 967(74.7%) residents were followed in 2017. The rest of 328(25.3%) residents were excluded for the loss to follow-up due to loss of contact, death, rejection, move out, etc. Of all the knees(n¼1537) without RPFOA at baseline,139 knees (9.04%) developed incident RPFOA. That is to say, the incidence of RPFOA in knee level is annually 3.01% in this study. Different factors were tested for the relationship with incident RPFOA. Advanced age(OR¼1.037, 95% C...

No abstract

the last week. At 5, 8 and 10 years, participants were also asked to reported pain related to the left and right hip for the last week. For these measurements, we used the highest reported NRS score. We excluded postoperative scores of participants who received on hip replacement (HR, based on radiographs), and participants with less than 2 reported pain scores. We determined the slope of the fluctuation in pain per patient, the predicted values and the differences between real values and predicted values (¼residual). We defined clinical relevant difference in NRS-score of 1 point. A slope of >0.1 was defined as relevant increased pain at follow-up. A slope of <-0.1 was defined as relevant decreased pain at follow-up. Slopes between -0.1 and 0.1 we defined the pain as constant over the follow-up. The average of the absolute residuals are used to describe the fluctuation of pain between the measurements. An average of 1 suggests a pain course with minor fluctuations. For the present study we only included participants who reported hip pain at baseline. Results: 170 participants (mean age at baseline 55.7 year (±5.6); 75.9% female; mean body mass index (BMI) at baseline 25.5 (±3.6)) were included. WOMAC pain between baseline and 10 year follow up was not significant different (mean at baseline of 4.8 (sd 3.2), at 10 year 4.1 (sd 3.4), p¼0.66). The NRS score of most painful joint over the last week at baseline was not significantly different compared to the NRS of hip pain score at 10 year follow up (mean at baseline of 3.4 (sd 2.2), at 10 year 2.7 ((sd 2.6), p¼0.10). Data of 89% (n¼151) of the participants were used to determine the slope of fluctuation of pain. Decreased pain (slope<-0.1) was observed in 34% (n¼53) of the participants, of which 64% (n¼34) participants had minor fluctuations (1) ( figure 1a). The green line in the figures shows an example of the course of pain of one of the participants. Figure 1b shows that 36% (n¼19) of the participants with a decreasing pain with high fluctuations (>1). Constant pain was observed in 32% (n¼47) of the participants, of those 72% (n¼34) had minor fluctuations (figure 1c). Constant pain with high fluctuations (>1) was observed in 28% (n¼13) (figure 1d). Increasing pain was observed in 34% (n¼51) of the participants. Of them 73% (n¼37) had minor fluctuations (figure 1e) and can therefore be described as stable progressors. Conclusions: Although mean pain scores remain more or less stable over 10 years, different patterns in the natural course of pain could be identified. It suggest that individual pain scores tend to fluctuate over time. DIFFERENTIALPurpose: Pain at rest and pain with activity are two different manifestations of knee pain in osteoarthritis (OA) with different underlyingmechanisms and impact on patients and clinical relevance. Few, if any, discrete risk factors have been identified for these two types of knee pain in OA. We aimed to assess relations of knee effusions (KEs) and subchondral bone cysts (SBCs) to knee pain at rest or with walking. Methods...