Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada.
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia.
Br J Sports Med. 2017 May;51(10):781-790. doi: 10.1136/bjsports-2016-096768. Epub 2016 Dec 7.
Patellofemoral pain (PFP) occurs frequently, and may be related to patellofemoral osteoarthritis (PFOA). Obesity is associated with increased risk of knee OA. This systematic review involves a meta-regression and analysis to determine the relationship between body mass index (BMI) and PFP and PFOA, and to determine the link between BMI and interventional outcomes.
We searched seven electronic databases and reference lists of relevant papers and systematic reviews, for cross-sectional, prospective, human-based observational and interventional studies reporting BMI in individuals with PFP or PFOA compared to healthy controls. Two independent reviewers appraised methodological quality (epidemiological appraisal instrument). Where possible, data from prospective studies were pooled to conduct meta-regression and case-control, and intervention studies to conduct meta-analysis using the following categories: adolescents with PFP, adults with PFP and PFOA.
52 studies were included. We found greater BMI in adults with PFP (standardised mean difference: 0.24, 95% CI 0.12 to 0.36) and PFOA (0.73, 0.46 to 0.99) compared to healthy controls, but not in adolescents with PFP (-0.19, -0.56 to 0.18). We also observed statistical trends (p<0.10) towards higher BMI being a predictor for development of PFP in adults (0.34, -0.04 to 0.71). No significant link between BMI and intervention outcomes in adults with PFP was identified.
Higher BMI is present in PFP and PFOA, but not in adolescents with PFP.
CRD42015024812.
髌股疼痛（PFP）较为常见，可能与髌股骨关节炎（PFOA）有关。肥胖与膝关节骨关节炎（OA）风险增加相关。本系统综述进行了元回归和分析，以确定体重指数（BMI）与 PFP 和 PFOA 之间的关系，并确定 BMI 与介入治疗结果之间的联系。
我们检索了 7 个电子数据库和相关文献及系统综述的参考文献列表，以获取与 PFP 或 PFOA 患者相比健康对照组中 BMI 的横断面、前瞻性、基于人群的观察性和介入性研究。两位独立的审查员评估了方法学质量（流行病学评估工具）。在可能的情况下，对前瞻性研究的数据进行汇总，以进行荟萃回归和病例对照分析，对干预性研究进行荟萃分析，使用以下类别：青少年 PFP、成人 PFP 和 PFOA。
共纳入 52 项研究。我们发现 PFP 成人组（标准化均数差：0.24，95%置信区间 0.12 至 0.36）和 PFOA 成人组（0.73，0.46 至 0.99）的 BMI 更高，但青少年 PFP 组（-0.19，-0.56 至 0.18）并非如此。我们还观察到统计学趋势（p<0.10）表明 BMI 更高是成人 PFP 发展的预测因素（0.34，-0.04 至 0.71）。未发现 BMI 与成人 PFP 干预结果之间存在显著关联。
PFP 和 PFOA 患者的 BMI 较高，但青少年 PFP 患者的 BMI 则不然。
PROSPERO 注册号：CRD42015024812。
