Imaging detects independent risk factor of knee osteoarthritis
Malalignment of the knee joint was found to be an independent risk factor for the progression of knee osteoarthritis (OA), according to a study in the May issue of Arthritis and Rheumatism.

Stephanie Tanamas, MD, and colleagues from Monash University, Alfred Hospital in Victoria, Australia, systematically reviewed the evidence for a relationship between malalignment of the knee joint and progression and/or development of knee OA, including electronic searches of Medline, EMBase, and CINAHL, performed up to July 2008. They included radiographic or MRI studies that met a set of predefined criteria; 14 studies met the inclusion criteria and eight were considered high quality.

Tanamas and colleagues found limited evidence for an association between knee malalignment and incident knee OA, because only one cohort study examined this relationship.

However, the authors reported that there was strong evidence based on four high-quality cohort studies that knee malalignment is an independent risk factor for progression of radiographic knee OA. This finding was further supported by two high quality MRI cohort studies that found a relationship between varus and valgus alignment and structural progression of knee OA.

Given the paucity of investigation into the relationship between knee malalignment and risk of incident OA, the authors concluded further high-quality cohort studies are needed, and these may have important implications for the prevention of knee OA.
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