Malalignment: a possible target for prevention of incident knee osteoarthritis in overweight and obese women

Runhaar, Jos; Middelkoop, Marienke van; Reijman, Max; Vroegindeweij, Dammis; Oei, E.H.; Bierma-Zeinstra, Sita M A

doi:10.1093/rheumatology/keu141

Cited by 43 publications

(32 citation statements)

References 34 publications

(41 reference statements)

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“…In another report from the Osteoarthritis Initiative, among knees without knee OA at baseline, recent knee injury was associated with accelerated development of end-stage knee OA (33). In middle aged, overweight women without knee OA in the Prevention of Knee Osteoarthritis in Overweight Females study, varus alignment was associated with incident radiographic OA; the association for valgus was borderline (34). Serum leptin at baseline was associated with MRI lesions 10 yrs later in the Michigan Study of Women's Health Across the Nation (35).…”

Section: Resultsmentioning

confidence: 99%

Osteoarthritis year in review 2015: clinical

Sharma

2016

Osteoarthritis and Cartilage

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The purpose of this review is to highlight clinical research in osteoarthritis. A literature search was conducted using PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) with the search terms “osteoarthritis [All Fields] AND treatment [All Fields]” and the following limits activated: humans, English language, all adult 19+ years, published between April 1, 2014 and April 1, 2015. A second literature search was then conducted with the search terms “osteoarthritis [All Fields] AND epidemiology [All Fields]”, with the same limits. Reports of surgical outcome, case series, surgical technique, tissue sample or culture studies, trial protocols, and pilot studies were excluded. Of 1523, 148 were considered relevant. Among epidemiologic and observational clinical studies, themes included physical activity, early knee OA, and confidence/instability/falls. Symptom outcomes of pharmacologic treatments were reported for methotrexate, adalimumab, anti-nerve growth factor monoclonal antibodies, strontium ranelate, bisphosphonates, glucosamine, and chondroitin sulfate, and structural outcomes of pharmacologic treatments for strontium ranelate, recombinant human fibroblast growth factor 18, and glucosamine and chondroitin sulfate. Symptom outcomes of non-pharmacologic interventions were reported for: neuromuscular exercise, quadriceps strengthening, weight reduction and maintenance, TENS, therapeutic ultrasound, stepped care strategies, cognitive behavior therapy for sleep disturbance, acupuncture, gait modification, booster physical therapy, a web-based therapeutic exercise resource center for knee OA; hip physical therapy for hip OA; and joint protection and hand exercises for hand OA. Structure outcomes of non-pharmacologic interventions were reported for patellofemoral bracing.

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Section: Resultsmentioning

confidence: 99%

Osteoarthritis year in review 2015: clinical

Sharma

2016

Osteoarthritis and Cartilage

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“…Although knee alignment is a clear predictor of knee osteoarthritis progression [88], findings are inconsistent for knee osteoarthritis incidence [89]. A recent study [86] of overweight women without knee osteoarthritis found an association of varus alignment with incident radiographic but not symptomatic knee osteoarthritis. A meta-analysis reported greater odds of structural knee osteoarthritis progression with increasing knee adduction moment [87].…”

Section: Joint-level Risk Factorsmentioning

confidence: 99%

State of the evidence

Allen

Golightly

2015

Current Opinion in Rheumatology

314

178

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Purpose of review This review focuses on recent studies of osteoarthritis epidemiology, including research on prevalence, incidence, and a broad array of potential risk factors at the person level and joint level. Recent findings Studies continue to illustrate the high impact of osteoarthritis worldwide, with increasing incidence. Person-level risk factors with strong evidence regarding osteoarthritis incidence and/or progression include age, sex, socioeconomic status, family history, and obesity. Joint-level risk factors with strong evidence for incident osteoarthritis risk include injury and occupational joint loading; the associations of injury and joint alignment with osteoarthritis progression are compelling. Moderate levels of physical activity have not been linked to increased osteoarthritis risk. Some topics of high recent interest or emerging evidence for association with osteoarthritis include metabolic pathways, vitamins, joint shape, bone density, limb length inequality, muscle strength and mass, and early structural damage. Summary Osteoarthritis is a complex, multifactorial disease, and there is still much to learn regarding mechanisms underlying incidence and progression. However, there are several known modifiable and preventable risk factors, including obesity and joint injury; efforts to mitigate these risks can help to lessen the impact of osteoarthritis.

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“…It can occur secondary to meniscal tears 2,3 , but multiple other factors are related to extrusion, including higher age, obesity, history of knee trauma, malalignment and generalized osteoarthritis (OA) 4,5 . The generally accepted idea is that a displaced meniscus affects the weight-bearing and load distribution capacities within the knee joint, which leads to loss of cartilage and increase in bone marrow lesions, ultimately resulting in knee OA [6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Baseline meniscal extrusion associated with incident knee osteoarthritis after 30 months in overweight and obese women

Voet

Runhaar

Plas

et al. 2017

Osteoarthritis and Cartilage

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ObjectiveTo investigate the association between baseline meniscal extrusion and the incidence of knee osteoarthritis (KOA) after 30 months in a high-risk population of overweight and obese women, free of clinical and radiological knee OA at baseline. we determined the association between knees with and without meniscal extrusion and both outcomes, corrected for the baseline differences.Results 640 knees were available at baseline of which 24% (153) had meniscal extrusion. There was a significantly higher incidence of KOA according to the primary outcome measure in women with meniscal extrusion compared to those without extrusion (28.8%, OR 2.39, 95% CI 1.53, 3.73). A significantly higher incidence was found for the development of radiographic knee OA (12.4%, OR 2.61, 95% CI 1.11, 6.13) and medial JSN (11.8%, OR 3.19, 95% CI 1.59, 6.41). Meniscal extrusion was not significantly associated with clinical knee OA and lateral JSN. 4 ConclusionMeniscal extrusion was associated with a significantly higher incidence of KOA, providing an interesting target for early detection of individuals at risk for developing KOA.

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Malalignment: a possible target for prevention of incident knee osteoarthritis in overweight and obese women

Cited by 43 publications

References 34 publications

Osteoarthritis year in review 2015: clinical

Osteoarthritis year in review 2015: clinical

State of the evidence

Baseline meniscal extrusion associated with incident knee osteoarthritis after 30 months in overweight and obese women

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