Higher dynamic medial knee load predicts greater cartilage loss over 12 months in medial knee osteoarthritis
Objective Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in...
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| Veröffentlicht in: | Annals of the rheumatic diseases Jg. 70; H. 10; S. 1770 - 1774 |
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| Hauptverfasser: | , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
London
BMJ Publishing Group Ltd and European League Against Rheumatism
01.10.2011
BMJ Publishing Group Elsevier Limited |
| Schlagworte: | |
| ISSN: | 0003-4967, 1468-2060, 1468-2060 |
| Online-Zugang: | Volltext |
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| Abstract | Objective Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis. Methods A longitudinal cohort design utilising a subset of participants (n=144, 72%) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML). Results A higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months (β=29.9, 95% CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML. Conclusion This study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression. |
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| AbstractList | Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis.OBJECTIVEMechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis.A longitudinal cohort design utilising a subset of participants (n=144, 72%) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML).METHODSA longitudinal cohort design utilising a subset of participants (n=144, 72%) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML).A higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months (β=29.9, 95% CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML.RESULTSA higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months (β=29.9, 95% CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML.This study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression.CONCLUSIONThis study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression. Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis. A longitudinal cohort design utilising a subset of participants (n=144, 72%) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML). A higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months (β=29.9, 95% CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML. This study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression. Objective Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis. Methods A longitudinal cohort design utilising a subset of participants (n=144, 72%) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML). Results A higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months (β=29.9, 95% CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML. Conclusion This study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression. OBJECTIVE: Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis. METHODS: A longitudinal cohort design utilising a subset of participants (n=144, 72%) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML). RESULTS: A higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months ( beta =29.9, 95% CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML. CONCLUSION: This study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression. |
| Author | Wang, Yuanyuan Cicuttini, Flavia Bowles, Kelly-Ann Bennell, Kim L Hinman, Rana S Davies-Tuck, Miranda |
| Author_xml | – sequence: 1 givenname: Kim L surname: Bennell fullname: Bennell, Kim L email: k.bennell@unimelb.edu.au organization: Centre for Health, Exercise and Sports Medicine (CHESM), Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia – sequence: 2 givenname: Kelly-Ann surname: Bowles fullname: Bowles, Kelly-Ann email: k.bennell@unimelb.edu.au organization: Centre for Health, Exercise and Sports Medicine (CHESM), Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia – sequence: 3 givenname: Yuanyuan surname: Wang fullname: Wang, Yuanyuan email: k.bennell@unimelb.edu.au organization: Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Victoria, Australia – sequence: 4 givenname: Flavia surname: Cicuttini fullname: Cicuttini, Flavia email: k.bennell@unimelb.edu.au organization: Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Victoria, Australia – sequence: 5 givenname: Miranda surname: Davies-Tuck fullname: Davies-Tuck, Miranda email: k.bennell@unimelb.edu.au organization: Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Victoria, Australia – sequence: 6 givenname: Rana S surname: Hinman fullname: Hinman, Rana S email: k.bennell@unimelb.edu.au organization: Centre for Health, Exercise and Sports Medicine (CHESM), Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24512507$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/21742637$$D View this record in MEDLINE/PubMed |
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| Snippet | Objective Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee... Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This... OBJECTIVE: Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee... |
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| SubjectTerms | Aged Arthritis Biological and medical sciences Bone marrow Cartilage diseases Cartilage, Articular - pathology Cartilage, Articular - physiopathology Disease Progression Diseases of the osteoarticular system Epidemiologic Methods Female gait Gait - physiology Humans Joints Knee Knee Joint - pathology Knee Joint - physiopathology Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Mechanical properties Medical sciences Middle Aged Miscellaneous. Osteoarticular involvement in other diseases Osteoarthritis Osteoarthritis, Knee - pathology Osteoarthritis, Knee - physiopathology Risk factors Walking Walking - physiology Weight-Bearing - physiology |
| Title | Higher dynamic medial knee load predicts greater cartilage loss over 12 months in medial knee osteoarthritis |
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