Objectives Risk of knee osteoarthritis (OA) is much higher in women than in men. Previous studies have shown that bone shape is a risk factor for knee OA. However, few studies have examined whether knee bone shape differs between men and women. The purpose of the present study was to determine whether there are differences between men and women in knee bone shape. Methods We used information from the NIH-funded Osteoarthritis Initiative (OAI), a cohort of persons aged 45-79 at baseline who either had symptomatic knee OA or were at high risk of it. Among participants aged between 45 and 60 years, we randomly sampled 340 knees without radiographic OA (i.e., Kellgren/Lawrence grade of 0 in central readings on baseline radiograph). We characterized distal femur and proximal tibia shape of these selected radiographs using statistical shape modeling (SSM). We performed linear regression analysis to examine the association between sex and each knee shape mode (proximal tibia and distal femur), adjusting for age, race, body mass index (BMI) and clinic site. Results The mean age was 52.7 years (±4.3 SD) for both men and women. There were 192 female and 147 male knees for the distal femur analysis. Thirteen modes were derived for femoral shape, accounting for 95.5% of the total variance. Distal femur Mode 1 had the greatest difference in standardized score of knee shape between females and males (1.04, p<0.01); Modes 3, 5, 6, 8 and 12 were also significantly associated with sex. For tibial shape, 191 female knees and 149 male knees were used for the analysis. Ten modes explained 95.5% of shape variance. Of the significantly associated modes in the proximal tibia, Mode 2 had the greatest difference in standardized score of bone shape between males and females (−0.30, p=0.01); Modes 3 and 4 were also significantly associated. Conclusion The shapes of the distal femur and proximal tibia that form the knee joint differ by sex. Additional analyses are warranted to assess whether the difference in risk of OA between the sexes arises from bone shape differences.
Objective This study examined the association of proximal femur shape with ipsilateral medial and lateral compartment knee OA. Design Radiographs were obtained from the NIH-funded Osteoarthritis Initiative. Cases of isolated radiographic lateral compartment knee OA were defined on baseline radiographs as Kellgren/Lawrence (K/L) Grade > = 2 and joint space narrowing (JSN) > 0 in the lateral compartment and JSN=0 in the medial compartment; isolated medial compartment knee OA had K/L ≥ 2 and JSN > 0 medially with JSN=0 in the lateral compartment. Controls had K/L < 2 and JSN = 0 in both compartments. Controls were frequency matched to cases by sex and 10-year age intervals. We characterized the shape of the proximal femurs on radiographs using Active Shape Modeling and determined the association of proximal femur shape with knee OA using logistic regression. Results There were 168 lateral compartment knee OA cases (mean BMI 29.72 ±5.26), 169 medial compartment knee OA cases (mean BMI 29.68±4.83) and 168 controls (mean BMI 26.87±4.2). Thirteen modes were derived for femur shape which described 95.5% of the total variance in proximal femur shape in the population. Modes 6, 8 and 12 were associated with prevalent lateral compartment knee OA. Medial compartment knee OA was associated with proximal femur modes 1, 5, 8, and 12. Conclusions Prevalent lateral and medial compartment knee OA are associated with different ipsilateral proximal femur shapes. Additional studies are needed to better define how the shape of the proximal femur influences compartment specific knee OA.
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