Wang Bin, Liu Qiang, Wise Barton L, Ke Yan, Xing Dan, Xu Yuankun, Zhang Yuqing, Lin Jianhao
Arthritis Clinical and Research Center, Peking University People's Hospital, Beijing, China.
Departments of Internal Medicine and Orthopaedic Surgery, Davis School of Medicine, University of California, Sacramento, California, USA.
Int J Rheum Dis. 2018 Jul;21(7):1385-1390. doi: 10.1111/1756-185X.13079. Epub 2017 Apr 26.
To evaluate whether knee alignment explains the higher prevalence of lateral compartment tibiofemoral radiographic osteoarthritis (TFROA) among rural Chinese compared with that among Whites.
The Wuchuan OA Study is a population-based longitudinal study of risk factors for knee OA. At baseline 1030 participants had home interviews, clinical examinations and weight-bearing posteroanterior semi-flexed radiographs of the tibiofemoral joints. Anatomic knee alignment was measured using an e-film workstation and divided into three categories: normal (182°-184°), valgus (> 184°), and varus (< 182°) alignment. A knee was defined as having medial or lateral compartmental ROA if its Kellgren and Lawrence grade was ≥ 2 and joint space narrowing ≥ 1 in the medial or lateral compartment, respectively. We examined the association between knee alignment with prevalent medial or lateral knee ROA separately using multiple logistic regression.
Among 1030 participants, the proportions of knees with normal, valgus and varus alignment were 29.9%, 56.5% and 13.7%, respectively. The prevalence of medial and lateral ROA was 16.0% and 4.3%, respectively. Valgus alignment was associated with prevalence of lateral compartment ROA (odds ratio [OR] = 5.0, 95% CI: 2.4-10.5), while varus alignment was associated with medial compartment ROA (OR = 6.1, 95% CI: 4.4-8.6). The ratio of prevalence of lateral versus medial compartment TFROA was greater in Wuchuan than that in the Framingham OA Study and valgus malalignment was more common in Wuchuan than in the Rotterdam study.
The prevalence of compartment-specific TFROA differs between rural Chinese and Whites. This difference is likely due to relatively high prevalence of valgus malalignment in rural Chinese compared with that in Whites.
评估膝关节对线是否能解释中国农村人群相比于白人，其外侧胫股关节影像学骨关节炎（TFROA）患病率更高的原因。
武川骨关节炎研究是一项基于人群的膝关节骨关节炎危险因素纵向研究。在基线时，1030名参与者接受了家庭访谈、临床检查以及胫股关节负重后前半屈曲位X线片检查。使用电子胶片工作站测量解剖学膝关节对线，并分为三类：正常（182°-184°）、外翻（>184°）和内翻（<182°）对线。如果膝关节的凯尔格伦和劳伦斯分级≥2且内侧或外侧关节间隙狭窄分别≥1，则定义该膝关节患有内侧或外侧间室ROA。我们分别使用多元逻辑回归分析膝关节对线与内侧或外侧膝关节ROA患病率之间的关联。
在1030名参与者中，膝关节对线正常、外翻和内翻的比例分别为29.9%、56.5%和13.7%。内侧和外侧ROA的患病率分别为16.0%和4.3%。外翻对线与外侧间室ROA患病率相关（比值比[OR]=5.0，95%可信区间：2.4-10.5），而内翻对线与内侧间室ROA相关（OR=6.1，95%可信区间：4.4-8.6）。武川外侧与内侧间室TFROA患病率之比高于弗雷明汉骨关节炎研究，且武川外翻畸形比鹿特丹研究更为常见。
中国农村人群与白人之间特定间室TFROA的患病率存在差异。这种差异可能是由于中国农村人群外翻畸形患病率相比于白人相对较高所致。
