IS THE PFJ COMPARTMENT MORE RESPONSIBLE FOR KNEE MORBIDITY?

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How do pain and function vary with compartmental distribution and severity of radiographic knee osteoarthritis?
In OA affected knee identified by positive X-ray picture, how does radiographic severity and pattern of compartmental involvement influence symptoms? In a Population-based study of 819 adults aged >/=50 yrs with knee pain, Duncan R et al tried to find the answers.
He found:
1. It is the severity of radiographic disease within a compartment, rather than the distribution of radiographic disease between compartments that is associated with symptoms.
2. Positive X-ray in the PF joint is associated with symptoms, emphasizing the importance of radiographic changes in his joint.
How we must target physiotherapy for patellofemoral joint osteoarthritis?

The patellofemoral joint (PFJ) is one compartment of the knee that is frequently affected by osteoarthritis (OA) and is a potent source of OA symptoms. However, there is a dearth of evidence for compartment-specific treatments for PFJ OA.
Crossley KM et al evaluated whether a physiotherapy treatment, targeted to the PFJ, results in greater improvements in pain and physical function than a physiotherapy education intervention in people with symptomatic and radiographic PFJ OA.
A protocol suggested by Crossley KM et al for PFJ OA is as follows:
(i) Quadriceps muscle retraining; (ii) Quadriceps and hip muscle strengthening; (iii) Patellar taping; (iv) Manual PFJ and soft tissue mobilisation; and (v) OA education.
NB: Resistance and dosage of exercises will be tailored to the participant's functional level and clinical state.

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