The mediation effects of malalignment on the relation of sex to the risk of incidence tibiofemoral osteoarthritis
Authors' conclusion
Females had a higher risk of developing lateral TFROA than males; however, valgus malalignment only modestly explained such a difference.
Study context
- Population
- Knees without medial and lateral tibiofemoral radiographic OA in Multicenter Osteoarthritis Study (MOST) and Osteoarthritis Initiative (OAI)knees in MOST
- Participants
- 3,462 knees
- Exposure
- Females vs males; mediation through varus and valgus malalignment
- Outcome
- Incident medial and lateral TFROA; extent to which varus and valgus malalignment mediate sex differences
- Follow-up
- 7 years
Methodological detailsmediation analysis of MOST and OAI data, two cohorts (MOST and OAI)
- Mediation analysis of MOST and OAI data
- Two cohorts (MOST and OAI)
Main finding
As reported in the abstract
Incident lateral TFROA (MOST)
Females vs MalesEstimate (95% CI)
Incident lateral TFROA (MOST)
RR 2.31(1.73–3.08)
Accounting for 23% of total effect
RR of indirect effect via valgus malalignment 1.15(1.09–1.20)
Observational data: associations, not effects.
Further findings
| Outcome | RR (95% CI) | |
|---|---|---|
| Incident lateral TFROA, OAI cohort (n = 3095 knees) | 1.54 (1.15–2.04) | |
| 0.512Relative risk (log scale) |
- Incident lateral tibiofemoral radiographic osteoarthritis (TFROA), OAI cohort (n = 3095 knees) — RR of indirect effect of sex on lateral TFROA through valgus malalignment, accounting for 26% of total effect
- 1.10 (95% CI: 1.04 to 1.21)
Incident medial TFROA, MOST cohort
- No apparent sex difference in incident medial TFROA in MOST
- RR = 1.05, 95% CI: 0.89 to 1.25
Incident medial TFROA, OAI cohort
- No apparent sex difference in incident medial TFROA in OAI
- RR = 1.02, 95% CI: 0.84 to 1.19
Original publication
The mediation effects of malalignment on the relation of sex to the risk of incidence tibiofemoral osteoarthritis. Osteoarthritis Cartilage. Published 14 June 2024. doi:10.
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