Risk factors for lateral compartmental cartilage wear in varus knee osteoarthritis / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the gross features of articular cartilage wear in varus knee osteoarthritis, and discuss the risk factors for lateral compartmental cartilage erosion.</p><p><b>METHODS</b>Data prospectively collected from the dissection of 286 total knee arthroplasties (223 patients) with varus knee osteoarthritis from January 2013 to December 2013 were analyzed. At the operation, the gross assessments of articular cartilage, ligament and meniscus were recorded, and then the slices were evaluated for histologic analysis. Parameters of the patients with lateral compartmental cartilage erosion were compared with those without lateral compartmental cartilage erosion using the univariate analysis. Logistic regression analysis was used to analyze the risk factors associated with lateral compartmental cartilage erosion.</p><p><b>RESULTS</b>There were 223 patients with 286 knees were included,including 37 male patients (47 knees) and 189 female patients (239 knees), with an average age of (66±8) years (range 50-86 years), body mass index (BMI) was (27±5) kg/m2 (18.0-40.0 kg/m2). Varus degree was 8°±4° (1°-34°). Range of motion was 103°±21° (0°-143°), and Hospital for Special Surgery (HSS) score was 53±12 (29-76). Seventy-five knees (60 patients) showed lateral compartmental cartilage wear (26.2%). Environmental factors showed no differences in age, side, gender, BMI, range of motion,and HSS score (P>0.05). Factors significantly increasing the risk of lateral compartmental cartilage wear by univariate analysis included varus degree, activity level, duration of onset, meniscus, Weidow grade, Kellgren-Lawrence grade, collateral ligament and anterior cruciate ligament (P<0.05). Multiple Logistic regression analysis revealed the factors most highly associated with the increase risk for lateral compartmental wear were high activity level (OR=2.843, 95% CI 1.010-8.002) and longer duration of onset (OR=1.216, 95% CI 1.115-1.325). However, intact lateral meniscus (OR=0.012, 95% CI 0.003-0.048) and anterior cruciate ligament (OR=0.406, 95% CI 0.192-0.857) were associated with the protection of lateral compartmental.</p><p><b>CONCLUSIONS</b>In varus knee osteoarthritis, the wear incidence of lateral compartmental is low. High activity and increased duration of onset are risk factors of lateral compartmental wear, and intact meniscus and anterior cruciate ligament are protective factors.</p>