title: Association of Varus Thrust With Pain and Stiffness and Activities of Daily Living in Patients With Medial Knee Osteoarthritis.
abstract: BACKGROUND
  Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA).
  
  
  OBJECTIVE
  The aim of this study was to investigate the association between varus thrust and 2 subcategories-"pain and stiffness" and "activities of daily living (ADL)"-of the Japanese Knee Osteoarthritis Measure (JKOM).
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age ≥50 years, medial knee OA and Kellgren-Lawrence (K/L) grade ≥1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for varus alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed.
  
  
  RESULTS
  Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment (β=.17, P=.005). However, the association between varus thrust and ADL was not significant (β=.11, P=.058). Based on sensitivity analyses, including participants of K/L grade 1 had little influence on this analysis.
  
  
  CONCLUSIONS
  Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the cross-sectional design of this study.
  
  
  CONCLUSIONS
  Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance.
authors.affiliation: N. Fukutani, MSc, Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Fukutani
authors.affiliation: H. Iijima, MSc, Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Iijima
authors.affiliation: T. Fukumoto, MSc, Department of Physical Therapy, Faculty of Health Science, Kio University, Nara, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Fukumoto
authors.affiliation: D. Uritani, PhD, Department of Physical Therapy, Faculty of Health Science, Kio University.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Uritani
authors.affiliation: E. Kaneda, PhD, Nozomi Orthopaedic Clinic, Hiroshima, Japan.
authors.forename: Eishi
authors.initials: E
authors.lastname: Kaneda
authors.affiliation: K. Ota, PhD, Ota Orthopaedic Clinic, Kyoto, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ota
authors.affiliation: T. Aoyama, PhD, Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. aoyama.tomoki.4e@kyoto-u.ac.jp.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Aoyama
authors.affiliation: T. Tsuboyama, PhD, Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine.
authors.forename: Tadao
authors.initials: T
authors.lastname: Tsuboyama
authors.affiliation: S. Matsuda, PhD, Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Matsuda
mesh_terms: D000203:Activities of Daily Living; D017760:Bone Malalignment / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010147:Pain Measurement; D011859:Radiography; D014741:Video Recording; D016138:Walking / Q000502:physiology