The role of varus and valgus alignment in the initial development of knee cartilage damage by MRI: the MOST study.
The role of varus and valgus alignment in the initial development of knee cartilage damage by MRI: the MOST study.
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DOI：
10.1136/annrheumdis-2011-201070
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发表时间：
2013-02
影响因子：
27.4
通讯作者：
Nevitt M
中科院分区：
文献类型：
--
作者：
Sharma L;Chmiel JS;Almagor O;Felson D;Guermazi A;Roemer F;Lewis CE;Segal N;Torner J;Cooke TD;Hietpas J;Lynch J;Nevitt M
内翻和外翻对线与膝关节骨关节炎的进展有关，但它们在发病中的作用尚不确定。膝关节骨关节炎的影像学指标可能捕获早期进展，而不是疾病发展。我们检验了这个假设：在MRI显示软骨形态正常的膝关节中，内翻与内侧软骨损伤有关，外翻与外侧软骨损伤有关。在MOST中，对膝关节骨关节炎风险人群或膝关节骨关节炎患者进行了前瞻性研究，采集了基线全肢X线片以及基线和30个月MRI。在所有胫股亚区基线软骨形态正常的膝关节中，我们使用GEE逻辑回归来检查调整年龄、性别、BMI、松弛、膝关节撕裂和挤压后的对线和偶发软骨损伤之间的相关性。在1881个膝关节中，256人中的293个符合标准。内翻与非内翻与内侧损伤事件相关（调整后OR 3.59，95% CI：1.59，8.10），内翻与中立位也是如此，有剂量效应的证据（调整后OR 1.38/1°内翻，95% CI：1.19，1.59）。即使排除膝关节内侧踝关节损伤，结果也保持不变。外翻与外侧损伤事件无关。内翻和外翻分别与外侧和内侧损伤事件风险降低相关。在软骨形态正常的膝关节中，内翻与内侧间室的偶发性软骨损伤相关，内翻和外翻与负荷较小的间室的偶发性损伤风险降低相关。这些结果支持内翻增加膝关节骨关节炎初始发展的风险。
Varus and valgus alignment are associated with progression of knee osteoarthritis, but their role in incident disease is less certain. Radiographic measures of incident knee osteoarthritis may be capturing early progression rather than disease development. We tested the hypothesis: in knees with normal cartilage morphology by MRI, varus is associated with incident medial cartilage damage and valgus with incident lateral damage. In MOST, a prospective study of persons at risk for or with knee osteoarthritis, baseline full-limb x-rays and baseline and 30-month MRIs were acquired. In knees with normal baseline cartilage morphology in all tibiofemoral subregions, we used logistic regression with GEE to examine the association between alignment and incident cartilage damage adjusting for age, gender, BMI, laxity, meniscal tear, and extrusion. Of 1881 knees, 293 from 256 persons met criteria. Varus vs. non-varus was associated with incident medial damage (adjusted OR 3.59, 95% CI: 1.59, 8.10), as was varus vs. neutral, with evidence of a dose effect (adjusted OR 1.38/1° varus, 95% CI: 1.19, 1.59). Findings held even excluding knees with medial meniscal damage. Valgus was not associated with incident lateral damage. Varus and valgus were associated with a reduced risk of incident lateral and medial damage, respectively. In knees with normal cartilage morphology, varus was associated with incident cartilage damage in the medial compartment, and varus and valgus with a reduced risk of incident damage in the less loaded compartment. These results support that varus increases the risk for initial development of knee osteoarthritis.
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影响因子：
2.4
作者：
MORRISON, JB
通讯作者：
MORRISON, JB
DOI：
10.2106/00004623-198365020-00016
发表时间：
1983-01-01
影响因子：
5.3
作者：
HARRINGTON, IJ
通讯作者：
HARRINGTON, IJ
DOI：
10.1302/0301-620x.62b3.7410467
发表时间：
1980-01-01
影响因子：
--
作者：
JOHNSON, F;LEITL, S;WAUGH, W
通讯作者：
WAUGH, W
影响因子：
--
作者：
Hunter, DJ;Zhang, YQ;Felson, DT
通讯作者：
Felson, DT
影响因子：
4
作者：
Sled, Elizabeth A.;Sheehy, Lisa M.;Cooke, T. Derek V.
通讯作者：
Cooke, T. Derek V.