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Multicenter Study
. 2010 Nov;69(11):1940-5.
doi: 10.1136/ard.2010.129742. Epub 2010 May 28.

Varus and valgus alignment and incident and progressive knee osteoarthritis

Leena Sharma  1 , Jing Song, Dorothy Dunlop, David Felson, Cora E Lewis, Neil Segal, James Torner, T Derek V Cooke, Jean Hietpas, John Lynch, Michael Nevitt
Affiliations
Multicenter Study

Varus and valgus alignment and incident and progressive knee osteoarthritis

Leena Sharma et al. Ann Rheum Dis. 2010 Nov.

Abstract

Objective: Varus and valgus alignment increase medial and lateral tibiofemoral load. Alignment was associated with tibiofemoral osteoarthritis progression in previous studies; an effect on incident osteoarthritis risk is less certain. This study tested whether alignment influences the risk of incident and progressive radiographic tibiofemoral osteoarthritis.

Methods: In an observational, longitudinal study of the Multicenter Osteoarthritis Study cohort, full-limb x-rays to measure alignment were acquired at baseline and knee x-rays were acquired at baseline and knee x-rays at baseline and 30 months. Varus alignment was defined as ≤178° and valgus ≥182°. Using logistic regression and generalised estimating equations, the associations of baseline alignment and incident osteoarthritis at 30 months (in knees without baseline osteoarthritis) and alignment and osteoarthritis progression (in knees with osteoarthritis) were examined, adjusting. For age, gender, body mass index, injury, laxity and strength, with neutral knees as referent.

Results: 2958 knees (1752 participants) were without osteoarthritis at baseline. Varus (adjusted OR 1.49, 95% CI 1.06 to 2.10) but not valgus alignment was associated with incident osteoarthritis. 1307 knees (950 participants) had osteoarthritis at baseline. Varus alignment was associated with a greater risk of medial osteoarthritis progression (adjusted OR 3.59, 95% CI 2.62 to 4.92) and a reduced risk of lateral progression, and valgus with a greater risk of lateral progression (adjusted OR 4.85, 95% CI 3.17 to 7.42) and a reduced risk of medial progression.

Conclusion: Varus but not valgus alignment increased the risk of incident tibiofemoral osteoarthritis. In knees with osteoarthritis, varus and valgus alignment each increased the risk of progression in the biomechanically stressed compartment.

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Figures

Figure 1
Figure 1
The figure illustrates how the samples of 2958 knees for analyses of incident knee OA and 1307 knees for analyses of knee OA progression were derived.
See this image and copyright information in PMC

References

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