The relationship between knee adduction moment and cartilage and meniscus morphology in women with osteoarthritis

Summary Objective The aim of this cross-sectional study is to investigate the relationship between knee adduction moment and knee adduction angular impulse and meniscus, cartilage and bone morphology in women with knee osteoarthritis (OA). Method Forty-five women aged >40 years with OA in at least one knee, according to American College of Rheumatology clinical criteria were studied. The knee joint loading was assessed by three-dimensional motion analysis system during gait. Three Tesla magnetic resonance imaging (MRI) with a coronal T2-weighted spin echo sequence was used for evaluating meniscus pathology, and a coronal T1-weighted gradient echo sequence for quantifying cartilage morphology and bone surface size. Cartilage thickness, denuded area and subchondral area in the femorotibial joint was measured using custom software. Results A higher peak knee adduction moment was observed in participants with medial compared to those with lateral tears (2.92 ± 1.06 vs −0.46 ± 1.7, P < 0.001). Participants with a higher knee adduction moment displayed a larger medial meniscus extrusion ( r = 0.532, P < 0.001) and a lower medial meniscus height ( r = −0.395, P = 0.010). The inverse relationship was observed for the lateral meniscus. A higher knee adduction moment was also associated with a higher ratio of the medial to lateral tibial subchondral bone area ( r = 0.270, P = 0.035). By contrast, cartilage thickness and denuded areas in the femur and tibia were not related to the knee adduction moment. Similar results were found for the relationship between knee adduction angular impulse and meniscus, cartilage and bone morphology. Conclusions Dynamic knee joint loading is significantly related to meniscus pathology and bone size, but not to cartilage thickness in women with OA.