Higher dynamic medial knee load predicts greater cartilage loss over 12 months in medial knee osteoarthritis

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis. METHODS: A longitudinal cohort design utilising a subset of participants (n=144, 72 ) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML). RESULTS: A higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months (I?=29.9, 95 CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML. CONCLUSION: This study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression.
Original languageEnglish
Pages (from-to)1770 - 1774
Number of pages5
JournalAnnals of the Rheumatic Diseases
Volume70
Issue number10
DOIs
Publication statusPublished - 2011

Cite this

@article{68d5cb2b04c74308a756e9e71e9c6e3c,
title = "Higher dynamic medial knee load predicts greater cartilage loss over 12 months in medial knee osteoarthritis",
abstract = "Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis. METHODS: A longitudinal cohort design utilising a subset of participants (n=144, 72 ) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML). RESULTS: A higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months (I?=29.9, 95 CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML. CONCLUSION: This study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression.",
author = "Bennell, {Kim L} and Kelly-Ann Bowles and YuanYuan Wang and Flavia Cicuttini and Miranda Davies-Tuck and Rana Hinman",
year = "2011",
doi = "10.1136/ard.2010.147082",
language = "English",
volume = "70",
pages = "1770 -- 1774",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "BMJ Publishing Group",
number = "10",

}

Higher dynamic medial knee load predicts greater cartilage loss over 12 months in medial knee osteoarthritis. / Bennell, Kim L; Bowles, Kelly-Ann; Wang, YuanYuan; Cicuttini, Flavia; Davies-Tuck, Miranda; Hinman, Rana.

In: Annals of the Rheumatic Diseases, Vol. 70, No. 10, 2011, p. 1770 - 1774.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Higher dynamic medial knee load predicts greater cartilage loss over 12 months in medial knee osteoarthritis

AU - Bennell, Kim L

AU - Bowles, Kelly-Ann

AU - Wang, YuanYuan

AU - Cicuttini, Flavia

AU - Davies-Tuck, Miranda

AU - Hinman, Rana

PY - 2011

Y1 - 2011

N2 - Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis. METHODS: A longitudinal cohort design utilising a subset of participants (n=144, 72 ) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML). RESULTS: A higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months (I?=29.9, 95 CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML. CONCLUSION: This study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression.

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