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Multicenter Study
. 2025 Jun;33(6):745-752.
doi: 10.1016/j.joca.2025.04.007. Epub 2025 Apr 11.

The relation of walking forces to structural damage in the knee: The Multicenter Osteoarthritis Study

Lauren K Sara  1 , David T Felson  2 , Sarah Tilley  3 , Michael P LaValley  4 , Cora E Lewis  5 , John A Lynch  6 , Neil A Segal  7 , Ali Guermazi  8 , Frank Roemer  9 , Joshua J Stefanik  10 , Cara L Lewis  11
Affiliations
Multicenter Study

The relation of walking forces to structural damage in the knee: The Multicenter Osteoarthritis Study

Lauren K Sara et al. Osteoarthritis Cartilage. 2025 Jun.

Abstract

Objective: Mechanical loading is an important, modifiable risk factor for knee osteoarthritis. Identifying walking loads associated with disease worsening presents intervention opportunities. Our purpose was to evaluate the longitudinal relation of the baseline vertical ground reaction force (GRF) during walking to worsening bone marrow lesions (BMLs) and cartilage damage using cohort data from the Multicenter Osteoarthritis Study (MOST).

Methods: MOST participants with GRF data at baseline and magnetic resonance imaging examinations at baseline and 2-year follow-up were included. Peak impact force (PIF) and average loading rate (ALR) from the vertical GRF were analyzed with respect to four joint regions (i.e., the medial and lateral portions of the tibiofemoral and patellofemoral joints). Analyses used logistic regression with generalized estimating equations and adjusted for relevant covariates.

Results: Higher PIF was associated with increased odds of worsening BMLs in the lateral patellofemoral joint (odds ratio (95% confidence interval [CI]): 1.33 (1.11, 1.60)) and worsening cartilage damage in the lateral patellofemoral joint (1.48 (1.24, 1.77)), lateral tibiofemoral joint (1.24 (1.03, 1.50)), and medial tibiofemoral joint (1.25 (1.06, 1.48)). Higher ALR was associated with reduced odds of BML worsening in the lateral tibiofemoral joint (0.60 (0.41,0.87)).

Conclusions: Higher peak forces when walking were associated with worsening BMLs in the lateral patellofemoral joint and with worsening cartilage damage in regions of the knee associated with higher contact forces during walking. Higher ALRs were not associated with increased odds of structural worsening (BMLs or cartilage).

Keywords: Bone marrow lesions; Cartilage; Ground reaction force; Impact; Loading rate; MRI.

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Conflict of interest statement

Competing interests FWR is a shareholder and CMO of Boston Imaging Core Lab (BICL), LLC, a company providing radiologic image assessment services to academia and the pharmaceutical industry. He is a consultant to Grünenthal GmbH and is Editor in Chief of Osteoarthritis Imaging. NAS is a consultant for Pacira Biosciences and Trice Medical. AG is a shareholder of BICL, LLC and a consultant to Pfizer, Novartis, TissueGene, Medipost, Coval, ICM and Formation Bio. LKS, ST, MPL, and CLL declare no competing interests.

References

    1. Arden N, Nevitt MC. Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol Feb 2006;20(1):3–25. 10.1016/j.berh.2005.09.007 - DOI - PubMed
    1. Vina ER, Kwoh CK. Epidemiology of osteoarthritis: literature update. Curr Opin Rheumatol Mar 2018;30(2):160–7. 10.1097/bor.0000000000000479 - DOI - PMC - PubMed
    1. Steinmetz JD, Culbreth GT, Haile LM, Rafferty Q, Lo J, Fukutaki KG, et al. Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol 2023;5(9):e508–22. - PMC - PubMed
    1. Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis Jul 2014;73(7):1323–30. 10.1136/annrheumdis-2013-204763 - DOI - PubMed
    1. Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, et al. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med Oct 17 2000;133(8):635–46. 10.7326/0003-4819-133-8-200010170-00016 - DOI - PubMed

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