Relationships between Morphological Changes of Lower Limbs and Gender During Medial Compartment Knee Osteoarthritis

Yang, Liutao; Zheng, Zhong; Lv, Ji; Hao, Ruizheng; Yang, Yi‐Ping; Zhang, Yingze

doi:10.1111/os.12529

Cited by 14 publications

(14 citation statements)

References 36 publications

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“…However, it seems that varus malalignment has a stronger association with OA development and progression [ 87 , 88 ], because even in neutrally aligned knees and regardless of gender, the overall load passing through the medial tibiofemoral compartment is greater than the one passing through the lateral compartment [ 89 ]. Interestingly, there is evidence that women experience dynamic deformation of lower limb bones toward varus as OA of the knee medial compartment progresses, contributing to OA severity [ 41 ].…”

Section: Resultsmentioning

confidence: 99%

Gender-Related Aspects in Osteoarthritis Development and Progression: A Review

Peshkova

Лычагин

Lipina

et al. 2022

IJMS

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Osteoarthritis (OA) is a common degenerative joint disease treated mostly symptomatically before approaching its definitive treatment, joint arthroplasty. The rapidly growing prevalence of OA highlights the urgent need for a more efficient treatment strategy and boosts research into the mechanisms of OA incidence and progression. As a multifactorial disease, many aspects have been investigated as contributors to OA onset and progression. Differences in gender appear to play a role in the natural history of the disease, since female sex is known to increase the susceptibility to its development. The aim of the present review is to investigate the cues associated with gender by analyzing various hormonal, anatomical, molecular, and biomechanical parameters, as well as their differences between sexes. Our findings reveal the possible implications of gender in OA onset and progression and provide evidence for gaps in the current state of art, thus suggesting future research directions.

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Section: Resultsmentioning

confidence: 99%

Gender-Related Aspects in Osteoarthritis Development and Progression: A Review

Peshkova

Лычагин

Lipina

et al. 2022

IJMS

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“…In addition, the knee cartilage volume was generally smaller in women than that in men [ 41 ], and women have increased rates of cartilage loss and progression of cartilage defects at the knee than men [ 42 , 43 ]. Besides, as KOA progressed, both dynamic deformation of lower extremities and degeneration of articular cartilage could be found in females, while no obvious dynamic deformations were found in males [ 44 ]. These differences may lead to higher vulnerability of women to severe KOA potentially resulted by metabolic abnormalities and related inflammatory response in MetS, as compared with men.…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome and the incidence of knee osteoarthritis: A meta-analysis of prospective cohort studies

Nie

Yan

Zhou³

et al. 2020

PLoS ONE

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Background Cross-sectional studies suggest an association between metabolic syndrome (MetS) and knee osteoarthritis (KOA). We performed a meta-analysis to evaluate whether MetS is an independent risk factor for KOA. Methods Prospective cohort studies evaluating the association between MetS and KOA in general population were retrieved from PubMed and Embase. Only studies with multivariate analyses were included. Data were pooled with a random-effect model, which is considered to incorporate heterogeneity among the included studies. Results Five studies including 94,965 participants were included, with 18,990 people with MetS (20.0%). With a mean follow-up duration of 14.5 years, 2,447 KOA cases occurred. Pooled results showed that MetS was not significant associated with an increased risk of KOA after controlling of factors including body mass index (adjusted risk ratio [RR]: 1.06, 95% CI: 0.92~1.23, p = 0.40; I2 = 33%). Subgroup analysis showed that MetS was independently associated with an increased risk of severe KOA that needed total knee arthroplasty (RR = 1.16, 95% CI: 1.03~1.30, p = 0.02), but not total symptomatic KOA (RR = 0.84, 95% CI: 0.65~1.08, p = 0.18). Stratified analyses suggested that MetS was independently associated with an increased risk of KOA in women (RR = 1.23, 95% CI: 1.03~1.47, p = 0.02), but not in men (RR = 0.90, 95% CI: 0.70~1.14, p = 0.37). Conclusions Current evidence from prospective cohort studies did not support MetS was an independent risk factor of overall KOA in general population. However, MetS may be associated with an increased risk of severe KOA in general population, or overall KOA risk in women.

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“…1B ). 14 The HKA angle was defined as the medial angle between the mechanical axis of the tibia and the femur, 15 which represents lower‐limb alignment. Neutral alignment of the knee is represented by an HKA angle of 180°, while varus and valgus knee deformity is generally represented by an HKA angle <180° and >180°, respectively.…”

Section: Methodsmentioning

confidence: 99%

Computer‐aided Design of Distal Femoral Osteotomy for the Valgus Knee and Effect of Correction Angle on Joint Loading by Finite Element Analysis

Jin

Zhao

et al. 2022

Orthopaedic Surgery

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Objective Lateral open‐wedge distal femoral osteotomy (DFO) has been used to treat valgus deformity of the knee, with good clinical outcomes. However, there is a lack of biomechanical studies regarding the angle of correction. The objective of this study was to apply computer‐aided design (CAD) for osteotomy planning in a three‐dimensional (3D) anatomical model and to assess the biomechanical differences among the varying correction angles on joint loading by finite element analysis (FEA). Methods To model different angles of lateral open‐wedge DFO correction, the CAD software package Mimics 21.0 was used to accurately simulate the operated knee. The femur was cut to 0°, 2°, 4°, 6°, 8°, and 10° of varus (equivalent to hip‐knee‐ankle angles of 180°, 178°, 176°, 174°, 172°, and 170°, respectively). The original knee model and the corrected models were processed by FE software. Then, the FE models were subjected to an axial force to obtain the von Mises stress (VMS) and shear stress distributions within the femoral cartilages and menisci. Results Under a compressive load of 740 N, the highest VMS in lateral and medial compartments of the intact knee model was 3.418 and 3.303 MPa. The maximum value of both the VMS and the shear stress in the lateral compartment decreased as the varus angle increased, but the corresponding values in the medial compartment increased. When the hip‐knee‐ankle (HKA) angle was 180°, the VMS in the lateral and medial compartments was balanced (3.418 and 3.303 MPa, respectively). Meanwhile, when the HKA angle was 178° (3.488 and 3.625 MPa, respectively), the shear stress in the lateral and medial compartments was balanced. In addition, the magnitude of change in the stress was significantly higher in the medial compartment (90.9%) than in the lateral compartment (19.3%). Conclusion The optimal correction angle of the valgus knee is close to neutral alignment or slightly varus (0° ‐ 2°). Overcorrection is not recommended, as it can result in a steep increase of the stress within the medial compartment and may accelerate the process of medial compartment OA.

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Relationships between Morphological Changes of Lower Limbs and Gender During Medial Compartment Knee Osteoarthritis

Cited by 14 publications

References 36 publications

Gender-Related Aspects in Osteoarthritis Development and Progression: A Review

Gender-Related Aspects in Osteoarthritis Development and Progression: A Review

Metabolic syndrome and the incidence of knee osteoarthritis: A meta-analysis of prospective cohort studies

Computer‐aided Design of Distal Femoral Osteotomy for the Valgus Knee and Effect of Correction Angle on Joint Loading by Finite Element Analysis

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