Knee alignment linked to progression of knee osteoarthritis

סקירה זו באדיבות אתר מדיקונטקסט:WESTPORT, CT (Reuters Health) – In patients with primary knee osteoarthritis (OA), even a small misalignment of the knee increases the risk of disease progression, according to a report in The Journal of the American Medical Association for July 11.

Over 18 months, Dr. Leena Sharma, from Northwestern University Medical School, Chicago, and colleagues studied the effects of knee alignment among 237 individuals with primary knee OA.

The researchers found that after adjusting for age, sex and body mass index, baseline varus alignment was associated with a fourfold increase in the odds of medial OA progression. Similarly, baseline valgus malalignment was associated with an almost fivefold increase in the odds for lateral OA progression.

In addition, the severity of the malalignment was associated with greater medial and lateral joint space loss.

Dr. Sharma's group also found that a malalignment of more that 5% in both knees, in either direction, at baseline correlated with a significant deterioration in function over 18 months, compared with an malalignment of less than 5%.

"For clinicians these findings give them an idea of what is ahead for their patients," Dr. Sharma told Reuters Health. In addition, she said that because malalignment contributes to disease progression it might be a target for intervention.

These findings, she believes, support the need for studies to address the stresses that malalignment imposes on the knee. "There are a variety of conservative therapies that might address those stresses and…there are some surgical options," Dr. Sharma added.

JAMA 2001;286:188-195.

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