Patterns of compartment involvement in tibiofemoral osteoarthritis in men and women and in Caucasians and African Americans: The Multicenter Osteoarthritis Study.

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Abstract

OBJECTIVE: We conducted a cross-sectional study to describe the prevalence of tibiofemoral joint space narrowing (JSN) in medial and lateral compartments and assess whether it differs by gender and ethnic groups, and if it does, to what extent such a difference is accounted for by knee malalignment. METHODS: The NIH-funded Multicenter Osteoarthritis (MOST) Study is an observational study of persons age 50 to 79 years with either symptomatic knee OA or at high risk of disease. Knee radiographs were assessed for JSN in each tibiofemoral compartment. Mechanical axis angle was measured using full-limb films. We compared the proportion of knees with medial compartment JSN and with lateral JSN between men and women as well as Caucasians (CC) and African Americans (AA) using a logistic regression model adjusting for covariates (race or gender and BMI, age, education, clinic site), and used generalized estimating equations to account for correlation between two knees within a person. RESULTS: Of 5202 knees (2652 subjects), 1532 (29.5%) had medial JSN, and 427 (8.2%) had lateral JSN. Lateral JSN was more prevalent in women's than in men's knees (OR=1.9, 95% CI 1.5-2.4) and was also higher in knees of AA than in CC (OR=2.4, 95% CI: 1.7-3.3). Further adjustment for malalignment attenuated the OR for gender but not the OR for race. CONCLUSION: Women and AA are more likely to have lateral JSN than men and Caucasians. Valgus malalignment may contribute to the higher prevalence in women.

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