The knee adduction moment and knee osteoarthritis symptoms: relationships according to radiographic disease severity

Investigations of joint loading in knee osteoarthritis (OA) typically normalize the knee adduction moment to global measures of body size (eg, body mass, height) to allow comparison between individuals. However, such measurements may not reflect knee size. This study used a morphometric measurement of the cartilage surface area on the medial tibial plateau, which better represents medial knee size. This study aimed to determine whether normalizing the peak knee adduction moment and knee adduction moment impulse during gait to the medial tibial bone–cartilage interface could classify radiographic knee OA severity more accurately than traditional normalization techniques. Individuals with mild (N = 22) and severe (N = 17) radiographic knee OA participated. The medial tibial bone–cartilage interface was quantified from magnetic resonance imaging scans. Gait analysis was performed, and the peak knee adduction moment and knee adduction moment impulse were calculated in nonnormalized units and normalized to body mass, body weight × height, and the medial tibial bone–cartilage interface. Receiver operating characteristic curves compared the ability of each knee adduction moment normalization technique to classify participants according to radiographic disease severity. No normalization technique was superior at distinguishing between OA severities. Knee adduction moments normalized to medial knee size were not more sensitive to OA severity.

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The Relationship between Knee Adduction Moment and Knee Osteoarthritis Symptoms according to Static Alignment and Pelvic Drop

BioMed Research International ◽

10.1155/2019/7603249 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Yong Nie ◽

Hua Wang ◽

Bin Xu ◽

ZongKe Zhou ◽

Bin Shen ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Linear Models ◽

Knee Adduction Moment ◽

Radiographic Severity ◽

Negatively Associated ◽

Knee Oa ◽

Symptomatic Knee ◽

Radiographic Disease ◽

The Relationship ◽

Hss Score

Objectives. To investigate the relationship between external knee adduction moment (KAM) and knee osteoarthritis (OA) symptoms according to static alignment and pelvic drop. Methods. Ninety-five participants with symptomatic knee OA were included. Radiographic severity was graded by Kellgren and Lawrence (KL) scale. The hip-knee-ankle (HKA) angle was used to assess limb alignment from a full-length lower-limb radiograph. KAM-related variables (peak KAM and KAM impulse) and pelvic drop angle were determined from 3D gait analysis. Symptoms were assessed via visual analog scale (VAS) for pain and hospital for special surgery (HSS) score for physical function. The relationship between KAM and symptoms was evaluated according to radiographic severity and pelvic drop using linear models. Results. According to the more affected knee in the varus group, both the two KAM-related measures (peak KAM and KAM impulse) were positively associated with greater VAS pain and were negatively associated with HSS score. Only peak KAM was correlated with VAS and HSS in the valgus group. VAS pain score of the more affected knee was positively correlated with pelvic drop angle. Stratified by pelvic drop angle, KAM-related variables were more positively associated with VAS pain and negatively associated with HSS score for patients with pelvic drop angle ≤3 degrees. The relationships between KAM and symptoms according to radiographic disease severity remained confusing. Conclusions. Static alignment and pelvic drop angle significantly affected relationships between KAM-related variables and knee OA symptoms, which may explain the confusing results as shown by previous studies.

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Correlation of synovial fluid HMGB-1 levels with radiographic severity of knee osteoarthritis

Clinical & Investigative Medicine ◽

10.25011/cim.v34i5.15673 ◽

2011 ◽

Vol 34 (5) ◽

pp. 298 ◽

Cited By ~ 24

Author(s):

Zhan-Chun Li ◽

Guang-Qi Cheng ◽

Kong-Zu Hu ◽

Mao-Qiang Li ◽

Wei-Ping Zang ◽

...

Keyword(s):

Synovial Fluid ◽

Knee Osteoarthritis ◽

Disease Severity ◽

Multinomial Logistic Regression ◽

High Mobility ◽

Enzyme Linked Immunosorbent Assay ◽

Grading System ◽

Radiographic Severity ◽

Knee Oa ◽

Radiographic Disease

Purpose: This study measured high-mobility group box 1 (HMGB-1) levels in serum and synovial fluid (SF) in patients with primary knee osteoarthritis (OA) and correlated these levels with radiographic disease severity. Methods: Seventy-eight OA patients and 30 controls were enrolled in this study. All OA patients were scored according to the Kellgren-Lawrence (KL) grading system. HMGB-1 levels were measured by enzyme-linked immunosorbent assay (ELISA). Results: SF HMGB-1 levels were significantly higher in knee OA patients, compared with controls (P < 0.01). Moreover, SF HMGB-1 levels were positively associated with KL scores (P < 0.01). Multinomial logistic regression demonstrated that the SF HMGB-1 level was an independent factor for radiographic severity of OA (P=0.002); however, serum HMGB-1 levels did not differ significantly between OA patients and controls and did not correlate with KL scores (P > 0.05). Conclusion: These results demonstrate that HMGB-1 levels in SF of knee OA patients are independently associated with radiographic disease severity.

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