Elsevier

Osteoarthritis and Cartilage

Volume 18, Issue 11, November 2010, Pages 1380-1385
Osteoarthritis and Cartilage

Dynamic knee loading is related to cartilage defects and tibial plateau bone area in medial knee osteoarthritis

https://doi.org/10.1016/j.joca.2010.08.013Get rights and content
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Summary

Objective

To evaluate the relationship between dynamic mechanical loading, as indicated by external knee adduction moment (KAM) measures during walking, and measures of articular cartilage morphology and subchondral bone size in people with medial knee osteoarthritis (OA).

Design

180 individuals with radiographic medial tibiofemoral OA participated. Peak KAM and KAM angular impulse were measured by walking gait analysis. Tibial cartilage volume and plateau bone area, and tibiofemoral cartilage defects were determined from magnetic resonance imaging using validated methods.

Results

Both peak KAM (coefficient = 0.42, 95% confidence interval (CI) 0.04–0.79, P = 0.03) and KAM impulse (coefficient = 1.79, 95% CI 0.80–2.78, P < 0.001) were positively associated with the severity of medial tibiofemoral cartilage defects. KAM impulse was also associated with the prevalence of medial tibiofemoral cartilage defects (odds ratio 4.78, 95% CI 1.10–20.76, P = 0.04). Peak KAM (B = 0.05, 95% CI 0.01–0.09, P = 0.02) and KAM impulse (B = 0.16, 95% CI 0.06–0.25, P = 0.002) were positively associated with medial:lateral tibial plateau bone area, and KAM impulse was also associated with medial tibial plateau bone area (B = 133.7, 95% CI 4.0–263.3, P = 0.04). There was no significant association between KAM measures and tibial cartilage volume.

Conclusion

Peak KAM and KAM impulse are associated with cartilage defects and subchondral bone area in patients with medial knee OA, suggesting that increased mechanical loading may play a role in the pathological changes in articular cartilage and subchondral bone that occur with medial knee OA.

Keywords

Knee osteoarthritis
Cartilage morphology
Biomechanics
Gait

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