title: Incidence, prevalence, natural course and prognosis of patellofemoral osteoarthritis: the Cohort Hip and Cohort Knee study.
abstract: To examine the proportion of isolated patellofemoral osteoarthritis (PFOA) compared to tibiofemoral osteoarthritis (TFOA) in middle-aged participants with early osteoarthritis (OA) symptoms of the knee; to describe the natural course of PFOA compared with that of TFOA and to identify whether patients with PFOA have a different phenotype compared to patients with TFOA, or with combined PFOA and TFOA (combined osteoarthritis (COA)).
  
  
  
  Participants with early OA symptoms of the knee were selected, completed questionnaires, underwent physical examination, and had knee radiographs at baseline, and at 2 and 5 years follow-up. Based on radiographs, participants were classified as having isolated TFOA, isolated PFOA, COA, or no radiographic OA. Multivariate logistic regression was used to identify participant characteristics associated with a specific group of OA at 2 years follow-up.
  
  
  
  The cohort comprised 845 participants (mean age 55.9 years). At baseline, 116 had PFOA, none had TFOA or COA. Of these 116 participants, 66.3% had developed COA at 5 years follow-up. At 2 years follow-up, PFOA, TFOA and COA were present in 77 (10.8%), 39 (5.5%) and 83 (11.6%) participants, respectively. Multivariate regression analyses at 2 years follow-up showed that participants with radiographic PFOA or TFOA were not significantly different from each other with respect to signs and symptoms.
  
  
  
  These results suggest that OA is more likely to start in the patellofemoral joint and then progress to COA in individuals with symptoms of early knee OA. No differences in TFOA and PFOA phenotypes were determined with respect to signs and symptoms.
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
authors.forename: N E
authors.initials: NE
authors.lastname: Lankhorst
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Damen
authors.affiliation: Department of Radiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
authors.forename: E H
authors.initials: EH
authors.lastname: Oei
authors.affiliation: Department of Orthopaedics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
authors.forename: J A N
authors.initials: JAN
authors.lastname: Verhaar
authors.affiliation: Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Kloppenburg
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
authors.forename: S M A
authors.initials: SMA
authors.lastname: Bierma-Zeinstra
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. Electronic address: m.vanmiddelkoop@erasmusmc.nl.
authors.forename: M
authors.initials: M
authors.lastname: van Middelkoop
mesh_terms: D000368:Aged; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D010147:Pain Measurement; D057071:Patellofemoral Joint / Q000503:physiopathology*; D010808:Physical Examination / Q000379:methods; D015995:Prevalence; D011379:Prognosis; D011859:Radiography / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Cohort; Knee; Osteoarthritis; Patellofemoral joint; Tibiofemoral joint