The Study on the Classification and Pathogenesis of the Osteoarthritic Knee in Elderly

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Clinical and radiographical examination and comparison were carried out on one thousand two hundred fourty-two knees of 944 patients with osteoarthritis (OA) in out-patients clinic of the Yokohama City University Hospital and 311 knees of 229 patients with OA in Shanghai Second University Hospital. As to Japanese patients, there were 230 men and 714 women. The ratio of men to women was 1 : 3.1. The average age was 61.8<plus-minus>9.5 years. There were 627 right knees and 615 left knees, 1110 primary OA and 132 secondary OA. Body weight was 62.3<plus-minus>8.9 Kg in men and 55.4<plus-minus>9.5Kg in women. Both groups were heavier than those of normal persons of the same age. The antero-posterior radiographs of the knees, and the axial views (skyline views) of the patella were taken at the one-leg-standing position. The radiographical findings were classfied according to Ahlback's criteria by location of the joint space narrowing in three articulations : medial and lateral femorotibial, … More and patello-femoral articulation. Percentage of initial type without any joint space narrowing, medial type with medial femorotibial joint space narrowing, medial・ patello-femoral type and patello-femoral type was 30.3%, 41.9%, 19.6% and 2.1% respectively. The numbers of patients with more than 5 years duration since onset, with severe knee pains, with inability of formal sitting and squating and with limited distance in walking were seen more in the group of patients with joint space narrowing than that without. As to chinese patients, there were 88 men and 141 women. The ratio of men to women was 1 : 1.6. The average age was 52.3<plus-minus>11.7 years. There were 67 right knees and 158 left knees, 28 primary OA and 283 secondary OA. Percentage of initial type, medial type, medial・patello-femoral type and patello-femoral type were 49.5%, 3.5%, 15.4%, and 25.7% respectively. Clinical signs in the Chinese patients with joint space narrowing were as severe as those of Japanese ones. The number of the patients with patello-femoral type was more in China than in Japan. This difference seems to be caused by the fact that Chinese have no habit of formal sitting square, an habit of riding bicycle every day, light body weight and rather valgus alignment of the knees, and Chinese patients in this study were younger than Japane Less