Studies examining the relationship between BMI and patellofemoral structure.
| Study | Definition of Outcome | OA/non-OA | Variables Adjusted For | Results (95% CI or p value) | Conclusion |
|---|---|---|---|---|---|
| Patellar cartilage defects | |||||
| Cross-sectional studies: association between BMI and patellar cartilage defects | |||||
| Gunardi, et al26 | Patellar cartilage defects | Non-OA | Age, bone and cartilage volume | Increased odds of defects, OR 1.09 (1.03–1.16), p = 0.004 | Higher BMI significantly associated with increased odds of patellar cartilage defects in women |
| Teichtahl, et al27 | Patellar cartilage defects | Non-OA | Age | Men, increased odds of defects, OR 1.29 (95% CI 1.09–1.52), p = 0.003; women, increased odds of defects, OR 1.17 (95% CI 1.08–1.27), p < 0.0001 | Higher BMI was significantly associated with higher odds of patellar cartilage defects |
| Hanna, et al23 | Patellar cartilage defects | Non-OA | Age, bone volume | Increased odds of defects, OR 1.09 (95% CI 1.02–1.17), p = 0.01 | Higher BMI was significantly associated with higher odds of patellar cartilage defects in women |
| Ding, et al21 | Patellar cartilage defects | OA (17%), non-OA | Age, sex, case-control status, bone size, ROA | Increased odds of defects, OR 1.08 (95% CI 1.02–1.14) | Higher BMI was significantly associated with higher odds of patellar cartilage defects |
| Duran, et al22 | Patellar cartilage defects | Non-OA | Not adjusted | Mean BMI, no patellar cartilage defect vs patellar cartilage defect, 26 ± 4.0 vs 29 ± 4.3, p < 0.05 | Cartilage defect was associated with higher BMI |
| Longitudinal studies: association between change in BMI over previous period and patellar cartilage defects | |||||
| Gunardi, et al26 | Patellar cartilage defects | Non-OA | Age, bone and cartilage volume, baseline BMI | No increased odds of defects, OR 0.98 (0.87–1.12), p = 0.80 | No significant association between increased BMI and patellar cartilage defects in women |
| Teichtahl, et al27 | Patellar cartilage defects | Non-OA | Age, patellar cartilage volume | Men, no increased odds of defects, OR 1.18 (95% CI 0.86–1.63), p = 0.31; women, increased odds of defects, OR 1.22 (95% 1.03–1.47), p = 0.02 | Higher BMI was significantly associated with higher odds of patellar cartilage defects for women only |
| Longitudinal studies: association between baseline BMI and change in patellar cartilage defects | |||||
| Carnes, et al30 | Change in patellar cartilage defects | Knee cartilage defects: 18.2% medial femur, 8.9% lateral femur, and 38% patella | Age, sex, BMI, baseline cartilage volume, tibial bone size, ROA | No association, OR 0.97 (95% CI 0.92–1.02), p = 0.27 | No significant association between BMI and increase in patellar cartilage defects |
| Ding, et al32 | Change in cartilage defect | Cases were adult children of subjects who had a knee replacement for knee OA, controls were selected from electoral roll | Offspring-control status, baseline cartilage defects | Increase in patellar cartilage defect, OR 1.03, p = 0.38; decrease in patellar cartilage defect OR 0.99, p = 0.72 | BMI was not associated with increase or decrease in patellar cartilage defect |
| Wang, et al12 | Change in patellar cartilage defects | OA (8%) and non-OA | Age, sex, physical activity, baseline bone size | Association with progression of cartilage defects, regression coefficient: 0.034 (−;0.002 to 0.070), p = 0.06 | No significant association between BMI and patellar cartilage defects |
| Roemer, et al34 | Patellar cartilage morphology/defect semiquantitative measures, WORMS | 71.2% radiographic OA | Age, BMI, sex, presence of cartilage damage, subchondral bone marrow lesions, synovitis, effusion | BMI was not associated with cartilage loss in the patellofemoral joint, data were not presented by the authors | There was no effect of BMI on the patellofemoral joint cartilage loss |
| Longitudinal studies: association between change in BMI and change in patellar cartilage defect | |||||
| Bucknor, et al29 | Cartilage morphology scored by the WORMS system | No clinical OA | Age, sex, baseline BMI, PASE score, KL score | 5% increase in BMI was associated with progression of patellar cartilage lesion, OR 8.9 (95% CI 2.2–60.0), p = 0.006 | Higher BMI was significantly associated with worsening in patellar cartilage morphology |
| Patellar cartilage volume | |||||
| Cross-sectional studies: association between BMI and patellar cartilage volume | |||||
| Gunardi, et al26 | Patellar cartilage volume | Non-OA | Age, bone volume | β coefficient: −;13.1 (−25.7 to −;0.55), p = 0.04 | Higher BMI was associated with reduced cartilage volume in women |
| Teichtahl, et al27 | Patellar cartilage volume | Non-OA | Age | Women, patellar cartilage volume, regression coefficient: −15.8 (95% CI −;29.8 to −1.8), p = 0.03; men, patellar cartilage volume, regression coefficient: 7.5 (95% CI − 30.0 to 45.0), p = 0.69 | Higher BMI was significantly associated with reduced cartilage volume among women only |
| Hanna, et al23 | Patellar cartilage volume | Non-OA, middle-aged women | Age, bone volume | Relationship with patellar cartilage volume, regression coefficient: −12.6 (95% CI −25.3 to 0.1), p = 0.05 | Higher BMI was not associated with higher odds of reduced cartilage volume in women |
| Longitudinal studies: association between change in BMI over previous period and patellar cartilage volume | |||||
| Gunardi, et al26 | Patellar cartilage volume | Non-OA | Age, bone volume, baseline BMI | β coefficient: −27.0 (−52.6 to −1.5), p = 0.04 | Higher BMI significantly associated with reduced cartilage volume in women |
| Teichtahl, et al27 | Patellar cartilage volume | Non-OA | Age | Men, relationship between change in BMI and current patellar cartilage volume, regression coefficient: −1.6 (95% CI −83.3 and 80.0), p = 0.97; women, relationship between change in BMI and current patellar cartilage volume, regression coefficient: 7.3 (−25.7 to 40.4), p = 0.66 | Higher BMI was not significantly associated with loss of cartilage volume |
| Longitudinal studies: association between baseline BMI and change in patellar cartilage volume | |||||
| Antony, et al28 | Change in patellar cartilage volume | OA (14%), non-OA | Sex, age, offspring-control status, baseline bone size | BMI (highest tertile), loss of patellar cartilage volume, β: −0.24 (95% CI −0.37 to −0.10); BMI (middle tertile), loss of patellar cartilage volume, β: −0.01, (95% CI −0.15 to 0.13), p = NS; BMI (lowest tertile), loss of patellar cartilage volume, β : −0.07 (95% CI −0.21 to 0.08), p = NS | Higher BMI was significantly associated with loss of patellar cartilage volume but only among those in the highest BMI tertile |
| Teichtahl, et al35 | Annual change in patellar cartilage volume | Non-OA | Age, sex, baseline patella bone volume, participation in physical activity | Men, no association with annual change in patellar cartilage volume, regression coefficient: 2.9 (95% CI −2.2 to 8.0), p = 0.26; women, association with annual change in patellar cartilage volume, regression coefficient: 3.0 (0.5–5.6), p = 0.02 | Higher BMI was significantly associated with loss of patellar cartilage volume for women only |
| Hanna, et al33 | Change in patellar cartilage volume | Non-OA | Age, sex, initial patella bone volume | Association with loss of patellar cartilage volume, regression coefficient: 2.0 (95% CI −3.9 to 8.0), p = 0.51 | BMI did not affect rate of change of patellar cartilage volume |
| Cicuttini, et al31 | Change in patellar cartilage volume | OA (100%) | Age, sex | Association with loss of patellar cartilage volume, regression coefficient: −1.9 × 10−3 (95% CI −0.004 to 0.000), p = 0.04 | Higher BMI was significantly associated with increased loss of patellar cartilage volume |
| Longitudinal studies: association between change in BMI and change in patellar cartilage volume | |||||
| Teichtahl, et al35 | Annual change in patellar cartilage volume | Non-OA | Data not shown | Data not shown | No significant association between BMI and annual rate of patellar cartilage volume loss |
| Cartilage quality | |||||
| Cross-sectional studies: association between BMI and patellar cartilage quality | |||||
| Koff, et al24 | Average transverse relaxation (T2) time constant, increased measures signify structural change | OA (82.5%), non-OA | NA | BMI was positively associated with the average transverse relaxation time constant (T2) of patellar cartilage: r = 0.3, p < 0.0001 | Higher BMI was significantly associated with increased T2 values |
| Widmyer, et al25 | Cartilage strain | Asymptomatic | Matched age and sex | High BMI group has significantly thicker patellar cartilage compared with normal BMI group: p = 0.2 for diurnal strain, p = 0.05 for BMI, p = 0.3 for diurnal strain | There was no effect of BMI on the magnitude of the patellar strain |
BMI: body mass index; OA: osteoarthritis; WORMS: whole-organ magnetic resonance imaging score; ROA: radiographic OA; PASE: Psoriatic Arthritis Screening and Evaluation; KL score: Kellgren-Lawrence arthritis grading scale; NS: not significant; NA: not applicable.