Superolateral Hoffa’s fat pad (SHFP) oedema and patellar cartilage volume loss: quantitative analysis using longitudinal data from the Foundation for the National Institute of Health (FNIH) Osteoarthritis Biomarkers Consortium
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To determine the association of superolateral Hoffa’s fat pad (SHFP) oedema and patellofemoral joint structural damage in participants of Foundation for the National Institute of Health Osteoarthritis Biomarkers Consortium study.
Baseline and 24-month MRIs of 600 subjects were assessed. The presence of SHFP oedema (using 0–3 grading scale) and patellar morphology metrics were determined using baseline MRI. Quantitative patellar cartilage volume and semi-quantitative MRI osteoarthritis knee score (MOAKS) variables were extracted. The associations between SHFP oedema and patellar cartilage damage, bone marrow lesion (BML), osteophyte and morphology were evaluated in cross-sectional model. In longitudinal analysis, the associations between oedema and cartilage volume loss (defined using reliable change index) and MOAKS worsening were evaluated.
In cross-sectional evaluations, the presence of SHFP oedema was associated with simultaneous lateral patellar cartilage/BML defects and inferior-medial patellar osteophyte size. A significant positive correlation between the degree of patella alta and SHFP oedema was detected (r = 0.259, p < 0.001). The presence of oedema was associated with 24-month cartilage volume loss (odds ratio (OR) 2.11, 95% confidence interval 1.46–3.06) and medial patellar BML size (OR 1.92 (1.15–3.21)) and number (OR 2.50 (1.29–4.88)) worsening. The optimal cut-off value for the grade of baseline SHFP oedema regarding both presence and worsening of patellar structural damage was ≥ 1 (presence of any SHFP hyperintensity).
The presence of SHFP oedema could be considered as a predictor of future patellar cartilage loss and BML worsening, and an indicator of simultaneous cartilage, BML and osteophyte defects.
• SHFP oedema was associated with simultaneous lateral patellar OA-related structural damage.
• SHFP oedema was associated with longitudinal patellar cartilage loss over 24 months.
• SHFP oedema could be considered as indicator and predictor of patellar OA.
KeywordsCartilage Knee Magnetic resonance imaging Osteoarthritis Patella
Anterior cruciate ligament
Analysis of variance
Area under the curve
Body mass index
Bone marrow lesion
Dual echo at steady state
Foundation for the National Institute of Health
Joint space loss
Magnetic resonance imaging osteoarthritis knee score
Multicenter Osteoarthritis Study
Magnetic resonance imaging
Physical activity scale for elderly
Reliable change index
Receiver operating characteristic
Superolateral Hoffa’s fat pad
Trochlear groove depth
Turbo spin echo
Tibial tuberosity trochlear groove
Western Ontario & McMaster Universities osteoarthritis
Whole-organ magnetic resonance score
The authors would like to thank the study participants and the staff involved in FNIH projects.
Compliance with ethical standards
The scientific guarantor of this publication is Dr. Ali Guermazi.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was not required for this study because we used an open access OAI database. All enrolled subjects in the OAI study gave informed consent.
Institutional review board approval was not required because we used an open access OAI database. The OAI study has received ethics board approval by the institutional review board at the University of California, San Francisco (OAI Coordinating Centre; Approval Number 10-00532).
Study subjects or cohorts overlap
Some study subjects or cohorts have been previously reported in the OAI database and OAI-related articles.
• multicentre study
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