Radiographic measures of settlement phenomenon in patients with medial compartment knee osteoarthritis

Dong, Tieli; Chen, Wei; Zhang, Fei; Yin, Bing; Tian, Ye; Zhang, Yingze

doi:10.1007/s10067-015-3146-0

Cited by 58 publications

(74 citation statements)

References 23 publications

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“…suggested that malalignment of the lower limbs, such as varus deformity, would lead to a gradual increase in the load of the medial compartment of the knee joint, which would greatly escalate the risk of the progression of knee osteoarthritis. The theory of “non‐uniform settlement” suggested that osteoporosis around the knee joint and the supporting effect of fibula lead to non‐uniform settlement of the knee joint, the medial tibial plateau collapsed under long‐term compressive stresses, which lead to alignment varus, more overloads on the medial compartment, degeneration of articular cartilage, and final knee varus and osteoarthritis. It showed that deformation was one of the pathogenic factors of KOA.…”

Section: Introductionsupporting

confidence: 81%

“…Knee varus is the morphological manifestation of medial compartment KOA. The phenomenon of “non‐uniform settlement” suggested that knee varus started at medial tibial plateau collapsed as long‐term pressure overload led to alignment varus, more overloads on the medial compartment, and degeneration of articular cartilage. Age was an important risk factor for KOA as it increased the length of weightbearing over time.…”

Section: Discussionmentioning

confidence: 99%

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

Yang

Zheng

et al. 2019

Orthopaedic Surgery

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ObjectivesTo evaluate the dynamic changes of key morphology indicators of the lower extremities in the coronal plane with progressing medial compartment knee osteoarthritis (KOA) with an emphasis on gender‐dependent regional differences.MethodsThe radiographs of patients with non‐traumatic knee pain and varying degrees of genu varus were reviewed. Radiographs were studied in 1538 lower limbs of 883 consecutive patients who visited our hospital from January to July 2017; all patients had long‐standing anteroposterior image‐splicing radiographs taken of their lower limbs. Morphological indicators of bones and joints that can change the alignment of lower limbs or reflect cartilage wear and soft‐tissue relaxation were selected and measured with the help of picture archiving and communication systems. After comparing the data of different genders, the data of males and females was separated into three age groups, <40 years, 40–60 years, >60 years respectively, and then compared among age groups using the Kruskal‐Wallis and Mann–Whitney U tests. Scatterplots of age and all the measurements were drawn to determine the strength of the relations. The Pearson correlation test was performed to reveal correlations of measurements and age.ResultsFemoral bowing angle (FBA) and joint line convergence angle (JLCA) have obvious differences between different genders (P = 0.001, 0.000, respectively). This suggests that females have greater femoral curvature and joint space angle than males. Significant differences were found in hip‐knee‐ankle angle (HKA), FBA, distal femoral valgus resection angle (DFVRA), medial proximal tibial angle (MPTA), JLCA, and minimum joint space width (min‐JSW) by age groups in females (P = 0.000, 0.000, 0.000, 0.000, 0.003, 0.002, respectively). The difference of mechanical medial distal femoral angle (mMDFA) was significant with P values less than 0.05 deemed significant (P = 0.030). Significant correlations were found between age and all measurements (r = −0.166, 0.253, 0.270, −0.147, 0.089, −0.105, −0.076, respectively, P < 0.01). Whereas, the difference in min‐JSW by age group was the only significant one in males (P = 0.001), and no significant correlation was found between age and measurements (r = −0.107, 0.041, 0.134, −0.067, 0.079, −0.134, −0.098, respectively, P > 0.01).ConclusionsAs 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. Dynamic deformation of lower extremities was the important feature and the major causative factor of KOA in females.

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Section: Introductionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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

Yang

Zheng

et al. 2019

Orthopaedic Surgery

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“…Risk of compartment‐specific progression in the analysis of medial OARSI grade progression increased in the presence of bipolar “kissing” defects, and risk of lateral OARSI grade progression increased in the presence of tibial defects. The higher rates of medial compared to lateral compartment progression are consistent with a higher prevalence of medial compartment OA seen in the general population …”

Section: Discussionsupporting

confidence: 64%

Role of full‐thickness cartilage defects in knee osteoarthritis (OA) incidence and progression: Data from the OA Initiative

Everhart

Abouljoud

Flanigan

2018

Journal Orthopaedic Research

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The purpose of this study is to determine whether full-thickness tibiofemoral cartilage defects are predictive of incident radiographic OA, progression of radiographic OA, and progression to severe radiographic OA. Participants in the OA Initiative (n = 1317, 38.1% male, mean age 60.9 years SD 9.2) with baseline MRIs and Kellgren-Lawrence (KL) OA grade 0-3 (none to moderate OA) were included. All participants had follow-up radiographs at mean 4.9 years (max 8.0). The effect of full-thickness defect presence, size, and location on risk of incident OA (KL grade 2+), overall progression of OA (increase in KL grade 1+ points), or compartment-specific OA progression was assessed with Cox proportional hazards modeling with adjustment for demographic factors, weight, and knee alignment. The yearly incidence of tibiofemoral OA was 0.3% (CI 0.2-0.4%); defect presence, size, and location were not associated with incident OA risk. The yearly rate of OA progression was 3.8% in participants without tibiofemoral full-thickness defects, 6.7% with medial defects, and 6.3% with lateral defects. Medial bipolar (kissing) lesions were an independent risk factor for OA progression as well as medial compartment progression. Lateral tibial-sided full-thickness defects increased risk of lateral progression (increase in lateral OARSI grade). In older adults, isolated full-thickness cartilage defects do not increase short-term risk of incident OA. However, in the setting of preexisting mild or moderate OA, medial bipolar (kissing) defects increase risk of overall OA progression (KL grade) as well as progression of medial compartment OA. Lateral tibial defects increase risk of lateral compartment OA progression. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

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“…According to the World Health Organization criteria (1994), the interpretation of the T score is as follows: T score >−1: normal, T score between −1 and −2.5: osteopenia, and T score <−2.5: osteoporosis. Hip X-ray examination was performed to diagnose the radiological signs of OA (Ravaud et al 1999). The Harris Hip Score (HHS) was also calculated in OA patients (Nilsdotter and Bremander 2011).…”

Section: Patients Populationmentioning

confidence: 99%

Comparison of tissue transglutaminase 2 and bone biological markers osteocalcin, osteopontin and sclerostin expression in human osteoporosis and osteoarthritis

et al. 2016

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Osteoporosis (OP) and osteoarthritis (OA) are the most common joint diseases, with a high incidence in the elderly population. OP is characterized by trabecular bone remodeling and reabsorption, whereas articular cartilage and subchondral bone remodeling are major features of OA. Although classically considered as independent or even conflicting processes, clinical coexistence of OP and OA was recently described. Transglutaminase 2 (TG2) expression is considered a biomarker of OA, but its role in osteoporotic bone remodeling is still uncertain. We investigated TG2 and bone biological markers (Osteocalcin, Osteopontin, and Sclerostin) in osteoporotic and osteoarthritic osteocartilagineous tissue (n = 54) and human chondrocyte cultures in vitro by immunohistochemistry, immunofluorescence and RT-PCR. Histomorphometric evaluation of bone trabecular remodeling was also performed. In cartilage, TG2 expression was faint in control and OP and significantly less than in OA and OP + OA chondrocytes; the opposite was found for Osteocalcin, whereas Osteopontin and Sclerostin expression was similar. In the subchondral trabecular bone, osteocytes/osteoblasts TG2 expression was slight and similar comparing control, OP, OA, and OP + OA group, whereas Osteocalcin and Osteopontin expression was lower in OP compared to control, OA and OP + OA. Increased TG2 and reduced Osteocalcin expression were maintained in human osteoarthritic chondrocytes in vitro. Histomorphometric analysis confirmed reduced trabecular bone mass in OP and OP + OA compared with OA patients. TG2 represented a suitable biomarker of osteoarthritic chondrocyte activation, whereas osteocalcin and osteopontin characterized osteoporotic osteocyte/osteoblast changes; differences were lost in OP + OA patients, suggesting careful consideration when coexistence of the two diseases occurs.

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Radiographic measures of settlement phenomenon in patients with medial compartment knee osteoarthritis

Cited by 58 publications

References 23 publications

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

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

Role of full‐thickness cartilage defects in knee osteoarthritis (OA) incidence and progression: Data from the OA Initiative

Comparison of tissue transglutaminase 2 and bone biological markers osteocalcin, osteopontin and sclerostin expression in human osteoporosis and osteoarthritis

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