Relationship Between Periosteal Reaction and Medial Compartment Knee Osteoarthritis in Observation of Chinese Patients: A Retrospective Single-Centre Comparative Study

Abstract

Background: The purpose of this study to evaluate the potential relationship between the periosteal reaction and medial compartment knee osteoarthritis (KOA), and to assess the related risk factors for the development of periosteal reaction associated with medial compartment KOA.Methods: From January 2019 to December 2019, a total of 476 consecutive patients with medial compartment KOA were included and assessed in this retrospective comparative study. They were divided into two groups: periosteal reaction group and non-periosteal reaction group. Radiological parameters was measured for malalignment of the lower extremities in coronal plane. Intra-observer and inter-observer reliabilities of all radiological measurements were analyzed by intraclass correlation coefficients (ICCs). Univariate analyses was conducted for comparison of differences with continuous variables between patients with periosteal reaction and without periosteal reaction. Multivariate binary logistical regression analysis were performed to determine the independent risk factors of radiographic parameters for periosteal reaction.Results: A total of 363 patients (726 knees) were selected for the study, including 91 males and 272 females, with an average age of 57.9±12.8 years (range, 18-82 years). The overall incidence of periosteal reaction associated with medial compartment KOA was 56.7%. Furthermore, the incidence of periosteal reaction significantly increased with age and K-L grade progressed (P＜0.05). Multivariate logistical regression analysis found that HKA and JICA were significantly correlated with the development of periosteal reaction adjacent to the lateral of proximal tibia diaphysis in medial compartment KOA (P＜0.05).Conclusions: Our observation of the reaction of periosteum may be an anatomical adaptation for medial compartment KOA. Patients with lower HKA and higher JICA are more likely to developing periosteal reaction, which occurred most commonly adjacent to the lateral of proximal tibia diaphysis.