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Self‐reported knee and foot alignments in early adult life and risk of osteoarthritis
Author(s) -
McWilliams Daniel F.,
Doherty Sally,
Maciewicz Rose A.,
Muir Kenneth R.,
Zhang Weiya,
Doherty Michael
Publication year - 2010
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.20169
Subject(s) - valgus , medicine , osteoarthritis , odds ratio , confidence interval , foot (prosody) , risk factor , logistic regression , physical therapy , knee joint , orthodontics , surgery , linguistics , philosophy , alternative medicine , pathology
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 OR int 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.