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Research project

Bone shape of the patellofemoral joint

Status: Ongoing (2015 -2020)

Influence of bone shape on patellofemoral pain and osteoarthritis.

What we do

About our project

So far, no study has compared subjects with and without PFP using 3D SSM in order to investigate the role of bone shape in the etiology of PFP. Therefore, the aim of the current study is to investigate differences in 3D patellar bone shape between PFP patients and healthy controls by applying modern 3D SSM techniques

The objective of the current proposal is to develop and apply a 3D shape model of the patellofemoral joint in order to investigate the influence of the joint geometry on patellofemoral pain and OA. We will investigate the hypotheses that:

  1. Bone shape of the patellofemoral joint is associated with the presence of patellofemoral pain;
  2. Bone shape of the patellofemoral joint is associated with the presence of patellofemoral OA;
  3. Similar bone shape variants are seen between young patients with patellofemoral pain and relatively older patients with patellofemoral OA.

For the current purpose, data of two studies will be used:

  1. A case-control study (TripleP study) investigating the causes of pain in patellofemoral pain patients;
  2. A population based cohort study with a 5-year follow-up of a nested cohort of the Rotterdam Study (RS-III), investigating early signs of OA.

A statistical shape model consists of a combination of modes of variation that together completely describe the shape of in our case the patella and femur. We will construct models of both the patella and femur separately as well as both combined.

Our research focus

Primary outcome
The primary outcome measure is the presence of a.) patellofemoral pain and b.) the presence of PF OA. Secondary outcome measures include the MOAKS features, i.e. BMLs, articular cartilage, and osteophytes and pain severity (NRS).

Funds & Grants

ReumaNederland (14-1-202)


Internal collaboration
Department of Radiology & Nuclear Medicine

External collaboration
Department of Biomechanical Engineering, Delft University of Technology, The Netherlands
Functional and Applied Biomechanics, Department of Rehabilitation Medicine, NIH, Bethesda, USA


1: Association Between Self-reported Measures, Physical Examination, and Early Magnetic Resonance Imaging Signs of Osteoarthritis in Patients With Patellofemoral Pain Eijkenboom JFA, et al. J Orthop Sports Phys Ther 2019. Among authors: van der Heijden RA, van Middelkoop M. PubMed PMID: 31291559.

2: Are Patellofemoral Joint Alignment and Shape Associated With Structural Magnetic Resonance Imaging Abnormalities and Symptoms Among People With Patellofemoral Pain? van Middelkoop M, et al. Am J Sports Med 2018. Among authors: van der Heijden RA, Eijkenboom JF. PubMed PMID: 30321064. PubMed Central PMCID: PMC6236631.

3: Is patellofemoral pain a precursor to osteoarthritis?: Patellofemoral osteoarthritis and patellofemoral pain patients share aberrant patellar shape compared with healthy controls Eijkenboom JFA, et al. Bone Joint Res 2018. Among authors: van Middelkoop M. PubMed PMID: 30294426. PubMed Central PMCID: PMC6168714.

Our team

J.F.A. Eijkenboom (PhD student), j.eijkenboom@erasmusmc.nl
Dr. M. van Middelkoop (co-promotor), m.vanmiddelkoop@erasmusmc.nl
Dr. E.O. Oei, e.oei@erasmusmc.nl
Dr. E. Waarsing, e.waarsing@erasmusmc.nl
Prof. S.M.A. Bierma-Zeinstra (promotor), s.bierma-zeinstra@erasmusmc.nl

Contact address for the project: j.eijkenboom@erasmusmc.nl.