Risk factor heterogeneity for medial and lateral compartment knee osteoarthritis: analysis of two prospective cohorts

Abstract

s u m m a r yObjective: To evaluate the etiologic heterogeneity between medial and lateral tibiofemoral radiographic osteoarthritis (ROA). Methods: Knees without medial or lateral tibiofemoral ROA at baseline were followed for 60-month in Multicenter Osteoarthritis Study (MOST) and for 48-month in Osteoarthritis Initiative (OAI). We examined the relation of previously reported risk factors to incident medial and lateral tibiofemoral ROA separately and determined the etiology heterogeneity with a ratio of rate ratios (RRs) (i.e., the RR for medial tibiofemoral ROA divided by the RR for lateral tibiofemoral ROA) using a duplication method for Cox proportional hazard regression. Results: Of 2,016 participants in MOST, 436 and 162 knees developed medial or lateral tibiofemoral ROA, respectively. Obesity and varus malalignment were 95% and 466% more strongly associated with incident medial tibiofemoral ROA than with lateral tibiofemoral ROA, respectively (ratios of RRs, 1.95 [95% confidence interval (CI):1.05e3.62] and 5.66 [95% CI:3.20e10.0]). In contrast, the associations of female sex and valgus malalignment with incident medial tibiofemoral ROA were weaker or in an opposite direction compared with lateral tibiofemoral Osteoarthritis (OA) (ratios of RRs, 0.40 [95% CI:0.26e0.63] and 0.20 [95% CI:0.12e0.34], respectively). Older age tended to show a weaker association with incident medial tibiofemoral ROA than with incident lateral tibiofemoral ROA. No heterogeneity was observed for the relation of race, knee injury, or contralateral knee ROA. These findings were closely replicated in OAI. Conclusion: Risk factor profiles for medial and lateral tibiofemoral ROA are different. These results can provide a framework for the development of targeted prevention and potential treatment strategies for specific knee OA subtypes.

T2 relaxation times of knee cartilage in 109 patients with knee pain and its association with disease characteristics

“…BMI showed a trend towards increasing T2 values with increasing BMI, but a significant association was seen only in the lateral tibial weight-bearing cartilage. This is in contradiction to the findings of a recent paper that found an association between obesity and the risk of developing medial tibiofemoral OA (Wei et al 2019 ). The range of T2 values in our study was between 35 and 50 ms, as can be seen in the scattorplots, which is in line with previously reported values (Oei et al 2014 ).…”

Identifying the Phenotypic and Temporal Heterogeneity of Knee Osteoarthritis: Data From the Osteoarthritis Initiative

“…Late pain subtype had medium changes in both subregion. Some studies found that greater BMI is associated with incident medial tibiofemoral OA ( 3 ) and more serious changes in lateral subregion in mean cartilage thickness, which is consistent with our results.…”

“…Previous study shows that risk of KOA increased with the incidence of contralateral knee OA ( 3 ). For the two knees of each subject which afflicted with KOA earlier and later, there may be different risk factors and disease progression patterns.…”

The association between asymptomatic hyperuricemia and knee osteoarthritis: data from the third National Health and Nutrition Examination Survey

“…the other (e.g., obesity is more strongly associated with medial disease, whereas female sex may be more strongly associated with lateral disease) 42 . One issue of possible concern is our use of the older NHANES III dataset rather than a more recent NHANES survey.…”