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. 2002 Jul;61(7):617–622. doi: 10.1136/ard.61.7.617

Dynamic load at baseline can predict radiographic disease progression in medial compartment knee osteoarthritis

T Miyazaki 1, M Wada 1, H Kawahara 1, M Sato 1, H Baba 1, S Shimada 1
PMCID: PMC1754164  PMID: 12079903

Abstract

Objective: To test the hypothesis that dynamic load at baseline can predict radiographic disease progression in patients with medial compartment knee osteoarthritis (OA).

Methods: During 1991–93 baseline data were collected by assessment of pain, radiography, and gait analysis in 106 patients referred to hospital with medial compartment knee OA. At the six year follow up, 74 patients were again examined to assess radiographic changes. Radiographic disease progression was defined as more than one grade narrowing of minimum joint space of the medial compartment.

Results: In the 32 patients showing disease progression, pain was more severe and adduction moment was higher at baseline than in those without disease progression (n=42). Joint space narrowing of the medial compartment during the six year period correlated significantly with the adduction moment at entry. Adduction moment correlated significantly with mechanical axis (varus alignment) and negatively with joint space width and pain score. Logistic regression analysis showed that the risk of progression of knee OA increased 6.46 times with a 1% increase in adduction moment.

Conclusions: The results suggest that the baseline adduction moment of the knee, which reflects the dynamic load on the medial compartment, can predict radiographic OA progression at the six year follow up in patients with medial compartment knee OA.

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Figure 1 .

Figure 1

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The mechanical axis (α) from the full length weightbearing AP radiograph of the leg.

Figure 2 .

Figure 2

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Receiver operating characteristic curves of the baseline adduction moment, mechanical axis, joint space width, and pain score for discriminating radiographic disease progression in medial compartment knee OA.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Altman R. D., Hochberg M., Murphy W. A., Jr, Wolfe F., Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage. 1995 Sep;3 (Suppl A):3–70. [PubMed] [Google Scholar]
  2. Andriacchi T. P. Dynamics of knee malalignment. Orthop Clin North Am. 1994 Jul;25(3):395–403. [PubMed] [Google Scholar]
  3. Cooke T. D., Li J., Scudamore R. A. Radiographic assessment of bony contributions to knee deformity. Orthop Clin North Am. 1994 Jul;25(3):387–393. [PubMed] [Google Scholar]
  4. Cooper C., Snow S., McAlindon T. E., Kellingray S., Stuart B., Coggon D., Dieppe P. A. Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthritis Rheum. 2000 May;43(5):995–1000. doi: 10.1002/1529-0131(200005)43:5<995::AID-ANR6>3.0.CO;2-1. [DOI] [PubMed] [Google Scholar]
  5. Davis M. A., Ettinger W. H., Neuhaus J. M., Cho S. A., Hauck W. W. The association of knee injury and obesity with unilateral and bilateral osteoarthritis of the knee. Am J Epidemiol. 1989 Aug;130(2):278–288. doi: 10.1093/oxfordjournals.aje.a115334. [DOI] [PubMed] [Google Scholar]
  6. Dieppe P. A., Cushnaghan J., Shepstone L. The Bristol 'OA500' study: progression of osteoarthritis (OA) over 3 years and the relationship between clinical and radiographic changes at the knee joint. Osteoarthritis Cartilage. 1997 Mar;5(2):87–97. doi: 10.1016/s1063-4584(97)80002-7. [DOI] [PubMed] [Google Scholar]
  7. Dieppe P., Cushnaghan J., Young P., Kirwan J. Prediction of the progression of joint space narrowing in osteoarthritis of the knee by bone scintigraphy. Ann Rheum Dis. 1993 Aug;52(8):557–563. doi: 10.1136/ard.52.8.557. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Doherty M., Belcher C., Regan M., Jones A., Ledingham J. Association between synovial fluid levels of inorganic pyrophosphate and short term radiographic outcome of knee osteoarthritis. Ann Rheum Dis. 1996 Jul;55(7):432–436. doi: 10.1136/ard.55.7.432. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Doherty M. Risk factors for progression of knee osteoarthritis. Lancet. 2001 Sep 8;358(9284):775–776. doi: 10.1016/S0140-6736(01)06006-8. [DOI] [PubMed] [Google Scholar]
  10. Dougados M., Gueguen A., Nguyen M., Thiesce A., Listrat V., Jacob L., Nakache J. P., Gabriel K. R., Lequesne M., Amor B. Longitudinal radiologic evaluation of osteoarthritis of the knee. J Rheumatol. 1992 Mar;19(3):378–384. [PubMed] [Google Scholar]
  11. Felson D. T., Naimark A., Anderson J., Kazis L., Castelli W., Meenan R. F. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum. 1987 Aug;30(8):914–918. doi: 10.1002/art.1780300811. [DOI] [PubMed] [Google Scholar]
  12. Felson D. T., Nevitt M. C. The effects of estrogen on osteoarthritis. Curr Opin Rheumatol. 1998 May;10(3):269–272. doi: 10.1097/00002281-199805000-00019. [DOI] [PubMed] [Google Scholar]
  13. Hart D. J., Spector T. D. The relationship of obesity, fat distribution and osteoarthritis in women in the general population: the Chingford Study. J Rheumatol. 1993 Feb;20(2):331–335. [PubMed] [Google Scholar]
  14. Hurwitz D. E., Ryals A. R., Block J. A., Sharma L., Schnitzer T. J., Andriacchi T. P. Knee pain and joint loading in subjects with osteoarthritis of the knee. J Orthop Res. 2000 Jul;18(4):572–579. doi: 10.1002/jor.1100180409. [DOI] [PubMed] [Google Scholar]
  15. Huskisson E. C., Berry H., Gishen P., Jubb R. W., Whitehead J. Effects of antiinflammatory drugs on the progression of osteoarthritis of the knee. LINK Study Group. Longitudinal Investigation of Nonsteroidal Antiinflammatory Drugs in Knee Osteoarthritis. J Rheumatol. 1995 Oct;22(10):1941–1946. [PubMed] [Google Scholar]
  16. Insall J. N., Ranawat C. S., Aglietti P., Shine J. A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am. 1976 Sep;58(6):754–765. [PubMed] [Google Scholar]
  17. Ledingham J., Regan M., Jones A., Doherty M. Factors affecting radiographic progression of knee osteoarthritis. Ann Rheum Dis. 1995 Jan;54(1):53–58. doi: 10.1136/ard.54.1.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Messieh S. S., Fowler P. J., Munro T. Anteroposterior radiographs of the osteoarthritic knee. J Bone Joint Surg Br. 1990 Jul;72(4):639–640. doi: 10.1302/0301-620X.72B4.2380220. [DOI] [PubMed] [Google Scholar]
  19. O'Reilly S. C., Muir K. R., Doherty M. Occupation and knee pain: a community study. Osteoarthritis Cartilage. 2000 Mar;8(2):78–81. doi: 10.1053/joca.1999.0274. [DOI] [PubMed] [Google Scholar]
  20. Radin E. L., Rose R. M. Role of subchondral bone in the initiation and progression of cartilage damage. Clin Orthop Relat Res. 1986 Dec;(213):34–40. [PubMed] [Google Scholar]
  21. Ravaud P., Giraudeau B., Auleley G. R., Drape J. L., Rousselin B., Paolozzi L., Chastang C., Dougados M. Variability in knee radiographing: implication for definition of radiological progression in medial knee osteoarthritis. Ann Rheum Dis. 1998 Oct;57(10):624–629. doi: 10.1136/ard.57.10.624. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Schipplein O. D., Andriacchi T. P. Interaction between active and passive knee stabilizers during level walking. J Orthop Res. 1991 Jan;9(1):113–119. doi: 10.1002/jor.1100090114. [DOI] [PubMed] [Google Scholar]
  23. Schouten J. S., van den Ouweland F. A., Valkenburg H. A. A 12 year follow up study in the general population on prognostic factors of cartilage loss in osteoarthritis of the knee. Ann Rheum Dis. 1992 Aug;51(8):932–937. doi: 10.1136/ard.51.8.932. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Sharif M., George E., Shepstone L., Knudson W., Thonar E. J., Cushnaghan J., Dieppe P. Serum hyaluronic acid level as a predictor of disease progression in osteoarthritis of the knee. Arthritis Rheum. 1995 Jun;38(6):760–767. doi: 10.1002/art.1780380608. [DOI] [PubMed] [Google Scholar]
  25. Sharif M., Saxne T., Shepstone L., Kirwan J. R., Elson C. J., Heinegård D., Dieppe P. A. Relationship between serum cartilage oligomeric matrix protein levels and disease progression in osteoarthritis of the knee joint. Br J Rheumatol. 1995 Apr;34(4):306–310. doi: 10.1093/rheumatology/34.4.306. [DOI] [PubMed] [Google Scholar]
  26. Sharma L., Hurwitz D. E., Thonar E. J., Sum J. A., Lenz M. E., Dunlop D. D., Schnitzer T. J., Kirwan-Mellis G., Andriacchi T. P. Knee adduction moment, serum hyaluronan level, and disease severity in medial tibiofemoral osteoarthritis. Arthritis Rheum. 1998 Jul;41(7):1233–1240. doi: 10.1002/1529-0131(199807)41:7<1233::AID-ART14>3.0.CO;2-L. [DOI] [PubMed] [Google Scholar]
  27. Sharma L., Song J., Felson D. T., Cahue S., Shamiyeh E., Dunlop D. D. The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA. 2001 Jul 11;286(2):188–195. doi: 10.1001/jama.286.2.188. [DOI] [PubMed] [Google Scholar]
  28. Spector T. D., Dacre J. E., Harris P. A., Huskisson E. C. Radiological progression of osteoarthritis: an 11 year follow up study of the knee. Ann Rheum Dis. 1992 Oct;51(10):1107–1110. doi: 10.1136/ard.51.10.1107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Spector T. D., Hart D. J., Nandra D., Doyle D. V., Mackillop N., Gallimore J. R., Pepys M. B. Low-level increases in serum C-reactive protein are present in early osteoarthritis of the knee and predict progressive disease. Arthritis Rheum. 1997 Apr;40(4):723–727. doi: 10.1002/art.1780400419. [DOI] [PubMed] [Google Scholar]
  30. Wada M., Imura S., Nagatani K., Baba H., Shimada S., Sasaki S. Relationship between gait and clinical results after high tibial osteotomy. Clin Orthop Relat Res. 1998 Sep;(354):180–188. doi: 10.1097/00003086-199809000-00022. [DOI] [PubMed] [Google Scholar]
  31. Wada M., Maezawa Y., Baba H., Shimada S., Sasaki S., Nose Y. Relationships among bone mineral densities, static alignment and dynamic load in patients with medial compartment knee osteoarthritis. Rheumatology (Oxford) 2001 May;40(5):499–505. doi: 10.1093/rheumatology/40.5.499. [DOI] [PubMed] [Google Scholar]

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