Is Indian osteoarthritis different? Emerging scenarios of disease pattern and implications for diagnosis and treatment of osteoarthritis in India

Abstract

<p class="abstract"><strong>Background:</strong> There are many studies to show comparative cartilage wear of medial and lateral compartment of knee. However, there are no studies in Indians that compare relative cartilage loss between femur and tibia.</p><p class="abstract"><strong>Methods:</strong> 44 patients with osteoarthritic knee at our center were posted for operative intervention in the form of partial or total knee arthroplasty and included in this study. Each patient had an magnetic resonance imaging (MRI) (cartogram) and weight bearing X-rays of the same knee. Intraoperative qualitative cartilage loss both femoral and tibial surfaces was observed and confirmed with preop findings of cartilage loss on X-ray or MRI.<strong></strong></p><p class="abstract"><strong>Results:</strong> The wear/loss of cartilage in 44 patients in femur is approximately twice that of tibia.</p><p class="abstract"><strong>Conclusions:</strong> Femoral cartilage loss is significantly more than tibia in Indians. These findings carry significance of not waiting for bone on bone arthritis to consider active treatment for Indian osteoarthritis patients. Bone on bone arthritis has so far been considered the litmus test for any intervention for osteoarthritis, even in India. Specific attention should rather be given to the femoral condyle clinically and radiologically. The authors have already described “The Dervan RIM sign” for the same purpose. The wear pattern is different from Caucasians and focus cannot be on joint space narrowing which is only with equally prevalent tibial and femoral cartilage wear.</p><p class="abstract"> </p>