Mechanical contributors to sex differences in idiopathic knee osteoarthritis

The occurrence of knee osteoarthritis (OA) increases with age and is more common in women compared with men, especially after the age of 50 years. Recent work suggests that contact stress in the knee cartilage is a significant predictor of the risk for developing knee OA. Significant gaps in knowled...

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Main Authors: Nicolella, Daniel P, O’Connor, Mary I, Enoka, Roger M, Boyan, Barbara D, Hart, David A, Resnick, Eileen, Berkley, Karen J, Sluka, Kathleen A, Kwoh, C Kent, Tosi, Laura L, Coutts, Richard D, Havill, Lorena M, Kohrt, Wendy M
Format: Online
Language:English
Published: BioMed Central 2012
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560206/
id pubmed-3560206
recordtype oai_dc
spelling pubmed-35602062013-02-04 Mechanical contributors to sex differences in idiopathic knee osteoarthritis Nicolella, Daniel P O’Connor, Mary I Enoka, Roger M Boyan, Barbara D Hart, David A Resnick, Eileen Berkley, Karen J Sluka, Kathleen A Kwoh, C Kent Tosi, Laura L Coutts, Richard D Havill, Lorena M Kohrt, Wendy M Review The occurrence of knee osteoarthritis (OA) increases with age and is more common in women compared with men, especially after the age of 50 years. Recent work suggests that contact stress in the knee cartilage is a significant predictor of the risk for developing knee OA. Significant gaps in knowledge remain, however, as to how changes in musculoskeletal traits disturb the normal mechanical environment of the knee and contribute to sex differences in the initiation and progression of idiopathic knee OA. To illustrate this knowledge deficit, we summarize what is known about the influence of limb alignment, muscle function, and obesity on sex differences in knee OA. Observational data suggest that limb alignment can predict the development of radiographic signs of knee OA, potentially due to increased stresses and strains within the joint. However, these data do not indicate how limb alignment could contribute to sex differences in either the development or worsening of knee OA. Similarly, the strength of the knee extensor muscles is compromised in women who develop radiographic and symptomatic signs of knee OA, but the extent to which the decline in muscle function precedes the development of the disease is uncertain. Even less is known about how changes in muscle function might contribute to the worsening of knee OA. Conversely, obesity is a stronger predictor of developing knee OA symptoms in women than in men. The influence of obesity on developing knee OA symptoms is not associated with deviation in limb alignment, but BMI predicts the worsening of the symptoms only in individuals with neutral and valgus (knock-kneed) knees. It is more likely, however, that obesity modulates OA through a combination of systemic effects, particularly an increase in inflammatory cytokines, and mechanical factors within the joint. The absence of strong associations of these surrogate measures of the mechanical environment in the knee joint with sex differences in the development and progression of knee OA suggests that a more multifactorial and integrative approach in the study of this disease is needed. We identify gaps in knowledge related to mechanical influences on the sex differences in knee OA. BioMed Central 2012-12-23 /pmc/articles/PMC3560206/ /pubmed/23259740 http://dx.doi.org/10.1186/2042-6410-3-28 Text en Copyright ©2012 Nicolella et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Nicolella, Daniel P
O’Connor, Mary I
Enoka, Roger M
Boyan, Barbara D
Hart, David A
Resnick, Eileen
Berkley, Karen J
Sluka, Kathleen A
Kwoh, C Kent
Tosi, Laura L
Coutts, Richard D
Havill, Lorena M
Kohrt, Wendy M
spellingShingle Nicolella, Daniel P
O’Connor, Mary I
Enoka, Roger M
Boyan, Barbara D
Hart, David A
Resnick, Eileen
Berkley, Karen J
Sluka, Kathleen A
Kwoh, C Kent
Tosi, Laura L
Coutts, Richard D
Havill, Lorena M
Kohrt, Wendy M
Mechanical contributors to sex differences in idiopathic knee osteoarthritis
author_facet Nicolella, Daniel P
O’Connor, Mary I
Enoka, Roger M
Boyan, Barbara D
Hart, David A
Resnick, Eileen
Berkley, Karen J
Sluka, Kathleen A
Kwoh, C Kent
Tosi, Laura L
Coutts, Richard D
Havill, Lorena M
Kohrt, Wendy M
author_sort Nicolella, Daniel P
title Mechanical contributors to sex differences in idiopathic knee osteoarthritis
title_short Mechanical contributors to sex differences in idiopathic knee osteoarthritis
title_full Mechanical contributors to sex differences in idiopathic knee osteoarthritis
title_fullStr Mechanical contributors to sex differences in idiopathic knee osteoarthritis
title_full_unstemmed Mechanical contributors to sex differences in idiopathic knee osteoarthritis
title_sort mechanical contributors to sex differences in idiopathic knee osteoarthritis
description The occurrence of knee osteoarthritis (OA) increases with age and is more common in women compared with men, especially after the age of 50 years. Recent work suggests that contact stress in the knee cartilage is a significant predictor of the risk for developing knee OA. Significant gaps in knowledge remain, however, as to how changes in musculoskeletal traits disturb the normal mechanical environment of the knee and contribute to sex differences in the initiation and progression of idiopathic knee OA. To illustrate this knowledge deficit, we summarize what is known about the influence of limb alignment, muscle function, and obesity on sex differences in knee OA. Observational data suggest that limb alignment can predict the development of radiographic signs of knee OA, potentially due to increased stresses and strains within the joint. However, these data do not indicate how limb alignment could contribute to sex differences in either the development or worsening of knee OA. Similarly, the strength of the knee extensor muscles is compromised in women who develop radiographic and symptomatic signs of knee OA, but the extent to which the decline in muscle function precedes the development of the disease is uncertain. Even less is known about how changes in muscle function might contribute to the worsening of knee OA. Conversely, obesity is a stronger predictor of developing knee OA symptoms in women than in men. The influence of obesity on developing knee OA symptoms is not associated with deviation in limb alignment, but BMI predicts the worsening of the symptoms only in individuals with neutral and valgus (knock-kneed) knees. It is more likely, however, that obesity modulates OA through a combination of systemic effects, particularly an increase in inflammatory cytokines, and mechanical factors within the joint. The absence of strong associations of these surrogate measures of the mechanical environment in the knee joint with sex differences in the development and progression of knee OA suggests that a more multifactorial and integrative approach in the study of this disease is needed. We identify gaps in knowledge related to mechanical influences on the sex differences in knee OA.
publisher BioMed Central
publishDate 2012
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560206/
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