McWilliams, Daniel F., Doherty, Sally A., Maciewicz, Rose A., Muir, Kenneth (Kenneth R.), Zhang, Weiya and Doherty, M., M.D.. (2010) Self-reported knee and foot alignments in early adult life and risk of osteoarthritis. Arthritis Care & Research, Vol.62 (No.4). pp. 489-495. ISSN 2151-464X

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Abstract

Objective. To determine whether self-reported early adult life malalignment of knees or feet are risk factors for knee or hip osteoarthritis (OA). Methods. Participants in the Genetics of Osteoarthritis and Lifestyle case-control database were sent a questionnaire (n = 3,022) containing line-drawing instruments for self-reported knee and foot alignment at ages 20-29 years. Respondents were categorized as having straight, valgus, or varus knee, and straight, toe-in, or toe-out feet. Radiographic criteria were used to define current isolated knee or hip OA, combined knee and hip OA, or non-OA controls. Odds ratios (ORs), adjusted ORs, and 95% confidence intervals (95% CIs) were calculated and logistic regression was performed. Results. The response rate was 72%; 87.5% of responders (n = 1,901) completed the alignment questions. Increased risk of isolated knee OA occurred with early adult varus (adjusted OR 5.16, 95% CI 2.87-9.41) and valgus knees (adjusted OR 3.16, 95% CI 1.04-9.64). The positive association between knee OA and toe-in foot was explained by varus knee. There was an increased risk of combined knee/hip OA from varus (adjusted OR 4.52, 95% CI 2.39-8.53) and valgus knees (adjusted OR 3.07, 95% CI 0.99-9.54). Varus knee was associated with risk of medial tibiofemoral OA, whereas valgus knee was associated with risk of lateral tibiofemoral and lateral patellofemoral OA. Toe-out foot was associated with reduced medial patellofemoral OA. For knee OA, a multiplicative interaction analysis between occupational risks and varus/valgus yielded an ORint of 3.20 (95% CI 1.08-9.49). Conclusion. Constitutional alignment of the leg in terms of varus or valgus knee or foot rotation may be a significant factor in determining development and distribution of knee but not hip OA.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	Arthritis Care & Research
Publisher:	Wiley-Blackwell Publishing Ltd.
ISSN:	2151-464X
Date:	April 2010
Volume:	Vol.62
Number:	No.4
Number of Pages:	7
Page Range:	pp. 489-495
Identification Number:	10.1002/acr.20169
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	AstraZeneca, Macclesfield, UK, Arthritis Research Campaign (ICAC)
Grant number:	14851
URI:	http://wrap.warwick.ac.uk/id/eprint/5395

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