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Challenges of identifying and treating patellofemoral osteoarthritis
  1. David T Felson
  1. Correspondence to Dr David T Felson, Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, 650 Albany Street, X-200, Boston 02118, MA, USA; dfelson{at}bu.edu

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Twenty-five per cent of persons aged 30 years and over experience knee pain on most days.1 For many, the pain is mild and avoidable but for a substantial number, it limits activity and diminishes the quality of life. The patellofemoral joint is often the source of this pain, especially among women. Among those 45 years and over, knee pain is most likely to be due to osteoarthritis (OA) and the patellofemoral joint is often affected.2 If osteoarthritic patellofemoral pain could be identified and treated successfully, it might offer opportunities to substantially reduce the burden of knee pain in the community among middle-aged and older persons.

How do we identify patellofemoral OA?

Patellofemoral osteoarthritic pain occurs in a knee with underlying OA, and usually patellofemoral and tibiofemoral compartments are affected. It is often extremely challenging to identify whether the pain is emanating from the patellofemoral joint or elsewhere in the knee. Much osteoarthritic pain originates in an inflamed synovium and most of the synovium is located superior to the patella. Therefore, when …

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