Proximal femur shape differs between subjects with lateral and medial knee osteoarthritis and controls: the Osteoarthritis Initiative

Kritikos, Lisa; Lynch, J.A.; Liu, Felix; Parimi, Neeta; Tileston, Kali; Nevitt, Michael C.; Lane, Nancy E.

doi:10.1016/j.joca.2014.08.013

Cited by 19 publications

(22 citation statements)

References 18 publications

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“…Our findings for the ipsilateral hip shape-knee rOA association are supported by a study of the Osteoarthritis Initiative cohort that reported an association between prevalent knee OA (lateral and medial compartments) with ipsilateral proximal femur shapes (15). In our study, Mode 2 reflects differences in the width of the femoral neck and size of the trochanters, while mode 3 is suggestive of variation in the width of the greater trochanter and femoral neck length (6).…”

Section: Discussionsupporting

confidence: 85%

Variations in Hip Shape Are Associated with Radiographic Knee Osteoarthritis: Cross-sectional and Longitudinal Analyses of the Johnston County Osteoarthritis Project

et al. 2015

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Objective Hip shape by statistical shape modeling (SSM) is associated with hip radiographic OA (rOA); we examined associations between hip shape and knee rOA given the biomechanical inter-relationships between these joints. Methods Bilateral baseline hip shape assessments (for those with at least 1 hip with Kellgren-Lawrence grade [KLG] 0 or 1) from the Johnston County Osteoarthritis Project were available. Proximal femur shape was defined on baseline pelvis radiographs and evaluated by SSM, producing mean shape and continuous variables representing independent modes of variation (14 modes=95% of shape variance). Outcomes included prevalent (baseline KLG >=2 or total knee replacement [TKR]), incident (baseline KLG 0/1 with follow-up >=2), and progressive (KLG increase of >=1 or TKR) knee rOA. Limb-based logistic regression models for ipsilateral and contralateral comparisons were adjusted for age, sex, race, body mass index (BMI), and hip rOA, accounting for intra-person correlations. Results We evaluated 681 hips and 682 knees from 342 individuals (61% women, 82% white, mean age 62 years, BMI 29 kg/m2). Ninety-nine knees (15%) had prevalent rOA (4 knees with TKR). Lower mode 2 and 3 scores were associated with ipsilateral prevalent knee rOA; only lower mode 3 scores were associated with contralateral prevalent knee rOA. No statistically significant associations were seen for incident or progressive knee rOA. Conclusions Variations in hip shape were associated with prevalent, but not incident or progressive, knee rOA in this cohort, and may reflect biomechanical differences between limbs, genetic influences, or common factors related to both hip shape and knee rOA.

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Section: Discussionsupporting

confidence: 85%

Variations in Hip Shape Are Associated with Radiographic Knee Osteoarthritis: Cross-sectional and Longitudinal Analyses of the Johnston County Osteoarthritis Project

et al. 2015

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“…The SSM methods used in this study are similar to methods described in previous publications (10). Radiographs where the edge of the knee extended beyond the border of the radiograph or where penetration was so poor that the edge of the knee could not be identified were eliminated because a complete shape could not be defined.…”

Section: Methodsmentioning

confidence: 99%

“…We have reported that several specific proximal femoral shapes, assessed by statistical shape modeling (SSM), are associated with incident radiographic hip OA in elderly women (9) and that proximal femoral shapes are associated with compartment-specific knee OA (10). Others have also reported that SSM-based knee shape is associated with severity of radiographic knee OA (11).…”

Section: Introductionmentioning

confidence: 99%

The association of distal femur and proximal tibia shape with sex: The Osteoarthritis Initiative

Liu

Kritikos

Lynch

et al. 2016

Seminars in Arthritis and Rheumatism

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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.

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“…Whereas links between different regions have been observed in disorders such as osteoarthritis (for example between hip shape and knee osteoarthritis in the study of osteoporotic fractures and the Johnston County studies; Wise et al. ; Nelson et al. ), and knee and lumbar spine in the Chingford study (Hassett et al.…”

Section: Introductionmentioning

confidence: 99%

Statistical shape modelling of hip and lumbar spine morphology and their relationship in the MRC National Survey of Health and Development

et al. 2017

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The anatomical shape of bones and joints is important for their proper function but quantifying this, and detecting pathological variations, is difficult to do. Numerical descriptions would also enable correlations between joint shapes to be explored. Statistical shape modelling (SSM) is a method of image analysis employing pattern recognition statistics to describe and quantify such shapes from images; it uses principal components analysis to generate modes of variation describing each image in terms of a set of numerical scores after removing global size variation. We used SSM to quantify the shapes of the hip and the lumbar spine in dual‐energy x‐ray absorptiometry (DXA) images from 1511 individuals in the MRC National Survey of Health and Development at ages 60–64 years. We compared shapes of both joints in men and women and hypothesised that hip and spine shape would be strongly correlated. We also investigated associations with height, weight, body mass index (BMI) and local (hip or lumber spine) bone mineral density. In the hip, all except one of the first 10 modes differed between men and women. Men had a wider femoral neck, smaller neck‐shaft angle, increased presence of osteophytes and a loss of the femoral head/neck curvature compared with women. Women presented with a flattening of the femoral head and greater acetabular coverage of the femoral head. Greater weight was associated with a shorter, wider femoral neck and larger greater and lesser trochanters. Taller height was accompanied by a flattening of the curve between superior head and neck and a larger lesser trochanter. Four of the first eight modes describing lumbar spine shape differed between men and women. Women tended to have a more lordotic spine than men with relatively smaller but caudally increasing anterior‐posterior (a‐p) vertebral diameters. Men were more likely to have a straighter spine with larger vertebral a‐p diameters relative to vertebral height than women, increasing cranially. A weak correlation was found between body weight and a‐p vertebral diameter. No correlations were found between shape modes and height in men, whereas in women there was a weak positive correlation between height and evenness of spinal curvature. Linear relationships between hip and spine shapes were weak and inconsistent in both sexes, thereby offering little support for our hypothesis.In conclusion, men and women entering their seventh decade have small but statistically significant differences in the shapes of their hips and their spines. Associations with height, weight, BMI and BMD are small and correspond to subtle variations whose anatomical significance is not yet clear. Correlations between hip and spine shapes are small.

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Proximal femur shape differs between subjects with lateral and medial knee osteoarthritis and controls: the Osteoarthritis Initiative

Cited by 19 publications

References 18 publications

Variations in Hip Shape Are Associated with Radiographic Knee Osteoarthritis: Cross-sectional and Longitudinal Analyses of the Johnston County Osteoarthritis Project

Variations in Hip Shape Are Associated with Radiographic Knee Osteoarthritis: Cross-sectional and Longitudinal Analyses of the Johnston County Osteoarthritis Project

The association of distal femur and proximal tibia shape with sex: The Osteoarthritis Initiative

Statistical shape modelling of hip and lumbar spine morphology and their relationship in the MRC National Survey of Health and Development

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