ABSTRACT
Osteoarthritis is a complex disease, affected by many factors, including genetic, environmental, traumatic and biomechanical factors. Patellofemoral arthritis found in approximately 5% of patients with osteoarthritis of the knee having symptomatic patellofemoral arthritis in the absence of tibiofemoral arthritis. The etiology of arthritis is equally divided among patellar dislocation, fracture, and primary osteoarthritis. The aim of this study was to evaluate the correlation of patellar alignment with knee pain and function in knee osteoarthritis. Sixty patients with osteoarthritis [OA] were included in our study. All patients were subjected to clinical assessment; body mass index, psychometric assessment using Center of Epidemiologic Studies Depression Scale [CES-D].Knee pain and function assessment using the Western Ontario and McMaster Universities [WOMAC] index; which includes visual analogue pain subscale and function scale. Laboratory investigations as; CBCs, ESR, uric acid and urine analysis. Radiological investigations; plain x-ray in weight bearing postero-anterior view for radiological grading of osteoarthritis using K- L score. Magnetic resonance image [MRI] is done in a sagittal plane to measure patellar length [PL], trochlear length [TL] then patellar length ratio [PLR] was calculated by dividing PL by TL.MRI is done in a transverse plane to measure trochlear indices [trochlear depth SA, inclination LTI and trochlear angle TA] and patellar indices [LPTA and BO]. There was a statistical significant increase of patellar length ratio [PLR] and lateral trochlear inclination [LTI] with WOMAC pain; there were no statistical significant difference of trochlear angle [TA] and sulcus angle [SA] with WOMAC pain. There was an increase of lateral patellar tilt angle [LPTA] and a decrease of bisect offset [BO] with WOMAC pain but; it didn't reach a statistical significant level. There was a tendency of lateral trocniear inclination [LTI] to increase with WOMAC function also; there was an increase of patellar length ratio with WOMAC function but it didn't reach a statistical significant level. The other parameters of patellar alignments measures [TA, SA, LPTA, BO] showed no significant change with WOMAC function. PF arthritis should be considered as an entity separate from arthritis of medial and lateral compartments. There is an association between patellar alignment with knee pain and function. So, procedures to improve patellar biomechanics to correct articular damage may be beneficial to alleviate pain