title: Varus-valgus alignment: reduced risk of subsequent cartilage loss in the less loaded compartment.
abstract: OBJECTIVE
  Varus-valgus alignment has been linked to subsequent progression of osteoarthritis (OA) within the mechanically stressed (medial for varus, lateral for valgus) tibiofemoral compartment. Cartilage data from the off-loaded compartment are sparse. The purpose of this study was to examine our hypotheses that neutral and valgus (versus varus) knees each have reduced odds of cartilage loss in the medial subregions and that neutral and varus (versus valgus) knees each have reduced odds of cartilage loss in the lateral subregions.
  
  
  METHODS
  Patients with knee OA underwent knee magnetic resonance imaging at baseline and 2 years. The mean cartilage thickness was quantified within 5 tibial and 3 femoral subregions. We used logistic regression with generalized estimating equations to analyze the relationship between baseline alignment and subregional cartilage loss at 2 years, adjusting for age, sex, body mass index, and disease severity.
  
  
  RESULTS
  A reduced risk of cartilage loss in the medial subregions was associated with neutral (versus varus) alignment (external tibial, central femoral, external femoral) and with valgus (versus varus) alignment (central tibial, external tibial, central femoral, external femoral). A reduced risk of cartilage loss in the lateral subregions was associated with neutral (versus valgus) alignment (central tibial, internal tibial, posterior tibial) and with varus (versus valgus) alignment (central tibial, external tibial, posterior tibial, external femoral).
  
  
  CONCLUSIONS
  Neutral and valgus alignment were each associated with a reduction in the risk of subsequent cartilage loss in certain medial subregions and neutral and varus alignment with a reduction in the risk of cartilage loss in certain lateral subregions. These results support load redistribution as an in vivo mechanism of the long-term alignment effects on cartilage loss in knee OA.
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Moisio
authors.forename: Alison
authors.initials: A
authors.lastname: Chang
authors.forename: Felix
authors.initials: F
authors.lastname: Eckstein
authors.forename: Joan S
authors.initials: JS
authors.lastname: Chmiel
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wirth
authors.forename: Orit
authors.initials: O
authors.lastname: Almagor
authors.forename: Pottumarthi
authors.initials: P
authors.lastname: Prasad
authors.forename: September
authors.initials: S
authors.lastname: Cahue
authors.forename: Ami
authors.initials: A
authors.lastname: Kothari
authors.forename: Leena
authors.initials: L
authors.lastname: Sharma
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena / Q000502:physiology; D017760:Bone Malalignment / Q000150:complications*; D002358:Cartilage, Articular / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control*; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016474:Weight-Bearing / Q000502:physiology