Mechanical contributors to sex differences in idiopathic knee osteoarthritis

Biology of Sex Differences

Daniel P Nicolella¹⁰  Mary I O’Connor⁵  Roger M Enoka⁴  Barbara D Boyan⁸  David A Hart¹²  Eileen Resnick¹  Karen J Berkley¹³  Kathleen A Sluka⁶  C Kent Kwoh⁹  Laura L Tosi³  Richard D Coutts⁷  Lorena M Havill¹¹  Wendy M Kohrt² 

[1] Isis Research Network on Musculoskeletal Health, Society for Women’s Health Research, Washington, DC, 20036, USA

[2] Division of Geriatric Medicine, University of Colorado Denver, Aurora, CO, 80045, USA

[3] Department of Orthopedic Surgery and Pediatrics, George Washington University, Washington, DC, 20010, USA

[4] Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA

[5] Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, 32224, USA

[6] Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, 52242, USA

[7] Department of Orthopedic Surgery, University of California, San Diego, San Diego, CA, 92123, USA

[8] Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA

[9] Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, 15261, USA

[10] Mechanical Engineering Division, Southwest Research Institute, San Antonio, TX, 78238, USA

[11] Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, 78245, USA

[12] Department of Surgery, University of Calgary, Calgary, AB, T2N 4N1, Canada

[13] Program of Neuroscience, Florida State University, Tallahassee, FL, 32306, USA

关键词: Sex differences;    Osteoarthritis;    Obesity;    Muscle function;    Limb alignment;    Knee joint;   

Others  :  793354
DOI  :  10.1186/2042-6410-3-28

 received in 2012-07-12, accepted in 2012-12-10,  发布年份 2012

【 摘 要 】

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.

【 授权许可】

   
2012 Nicolella et al.; licensee BioMed Central Ltd.

【 图 表 】

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