The following is a summary of “Mediation effects of malalignment on the relation of sex to the risk of incidence of tibiofemoral osteoarthritis,” published in the June 2024 issue of Rheumatology by Xin et al.
This study delves into the nuanced relationship between sex disparities and incident tibiofemoral radiographic osteoarthritis (TFROA), focusing particularly on the influence of knee malalignment as a potential explanatory factor. Drawing upon extensive data from the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative (OAI), investigators rigorously examined how sex impacts the development of both medial and lateral TFROA over longitudinal periods. The comprehensive analysis revealed compelling differences: females exhibited a striking 2.31-fold higher risk of developing incident lateral TFROA than males within the MOST cohort and a similarly notable 1.54-fold higher risk in the OAI cohort. To elucidate these findings further, researchers conducted mediation analyses to assess the extent to which valgus malalignment mediates the association between sex and lateral TFROA risk.
Intriguingly, valgus malalignment accounted for approximately 23% to 26% of the heightened risk observed in females across both study cohorts, suggesting a modest yet significant mediating effect. Notably, no significant sex-based disparities were observed in incident medial TFROA in either cohort, indicating a differential impact of sex on medial versus lateral joint compartments in the development of TFROA. These findings underscore the complex interplay between biological sex, joint biomechanics, and osteoarthritis risk, highlighting the need for nuanced approaches in understanding and addressing sex-specific vulnerabilities to TFROA. By elucidating these mechanisms, the study contributes valuable insights into the multifaceted etiology of TFROA, paving the way for targeted interventions and personalized management strategies to mitigate osteoarthritis risk in diverse patient populations.
Source: sciencedirect.com/science/article/abs/pii/S1063458424012597
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