title: Analysis of limb alignment in the pathogenesis of osteoarthritis: a comparison of Saudi Arabian and Canadian cases.
abstract: A study was made of alignment abnormalities and bone deformities in Saudis with osteoarthritis (SOA). Data from standardized radiography of hips and knees were: hip-knee-ankle angle (HKA), condylar-hip angle (CH), tibial plateau-ankle angle (PA), and joint surface (condylar-plateau) angle (CP). Females dominated the <50 years SOA subgroup (1.8:1), having also early onset OA with severe bowlegged deformity (mean HKA -11 degrees) and major shifts in CH, PA, and CP relative to normal parameters. In the females, links were noted between severe disease and osteomalacia or osteoporosis, requiring prospective studies. An association between femoral deformity (CH) and OA, first reported in Canadians with OA (COA), was confirmed in SOA (especially in males of all ages). The condition implies heightened mechanical risk of onset or progression at medial joint surfaces. Further, it calls for the fresh appraisal of surgical options based on biomechanical analysis of each case, including femoral osteotomy where necessary.
authors.affiliation: Dr. Sulaiman Al Habib Medical Center, Riyadh, Saudi Arabia. tdvcooke@shabakah.net.sa
authors.forename: T Derek V
authors.initials: TD
authors.lastname: Cooke
authors.forename: Laurie
authors.initials: L
authors.lastname: Harrison
authors.forename: Bashir
authors.initials: B
authors.lastname: Khan
authors.forename: Allan
authors.initials: A
authors.lastname: Scudamore
authors.forename: M Ashraf
authors.initials: MA
authors.lastname: Chaudhary
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods; D001696:Biomechanical Phenomena; D017760:Bone Malalignment / Q000175:diagnosis* / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016916:Joint Deformities, Acquired / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D011336:Probability; D016059:Range of Motion, Articular / Q000502:physiology; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012720:Severity of Illness Index; D017678:Sex Distribution