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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Vydané v:Annals of the rheumatic diseases Ročník 70; číslo 10; s. 1770 - 1774
Hlavní autori: Bennell, Kim L, Bowles, Kelly-Ann, Wang, Yuanyuan, Cicuttini, Flavia, Davies-Tuck, Miranda, Hinman, Rana S
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.10.2011
BMJ Publishing Group
Elsevier Limited
Predmet:
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
Knee
Cartilage
Knee osteoarthritis
Diseases of the osteoarticular system
Rheumatology
Arthropathy
Degenerative disease
Predictive factor
Osteoarthritis
Dynamic load
ISSN:0003-4967, 1468-2060, 1468-2060
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Shrnutí: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.
Bibliografia:istex:91ADF6D9AE87262B7CCD66BB46A18C46F7B0530D
href:annrheumdis-70-1770.pdf
ArticleID:annrheumdis-2010-147082
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PMID:21742637
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ISSN:0003-4967
1468-2060
1468-2060
DOI:10.1136/ard.2010.147082