Association of leg-length inequality with knee osteoarthritis a cohort study

William F. Harvey, Mei Yang, Theodore D V Cooke, Neil A. Segal, Nancy E Lane, Cora E. Lewis, David T. Felson

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Abstract

Background: Leg-length inequality is common in the general population and may accelerate development of knee osteoarthritis. Objective: To determine whether leg-length inequality is associated with prevalent, incident, and progressive knee osteoarthritis. Design: Prospective observational cohort study. Setting: Population samples from Birmingham, Alabama, and Iowa City, Iowa. Patients: 3026 participants aged 50 to 79 years with or at high risk for knee osteoarthritis. Measurements: The exposure was leg-length inequality, measured by full-limb radiography. The outcomes were prevalent, incident, and progressive knee osteoarthritis. Radiographic osteoarthritis was defined as Kellgren and Lawrence grade 2 or greater, and symptomatic osteoarthritis was defined as radiographic disease in a consistently painful knee. Results: Compared with leg-length inequality less than 1 cm, leg-length inequality of 1 cm or more was associated with prevalent radiographic (53% vs. 36%; odds ratio [OR], 1.9 [95% CI, 1.5 to 2.4]) and symptomatic (30% vs. 17%; OR, 2.0 [CI, 1.6 to 2.6]) osteoarthritis in the shorter leg, incident symptomatic osteoarthritis in the shorter leg (15% vs. 9%; OR, 1.7 [CI, 1.2 to 2.4]) and the longer leg (13% vs. 9%; OR, 1.5 [CI, 1.0 to 2.1]), and increased odds of progressive osteoarthritis in the shorter leg (29% vs. 24%; OR, 1.3 [CI, 1.0 to 1.7]). Limitations: Duration of follow-up may not be long enough to adequately identify cases of incidence and progression. Measurements of leg length, including radiography, are subject to measurement error, which could result in misclassification. Conclusion: Radiographic leg-length inequality was associated with prevalent, incident symptomatic, and progressive knee osteoarthritis. Leg-length inequality is a potentially modifiable risk factor for knee osteoarthritis.

Original languageEnglish (US)
Pages (from-to)287-295
Number of pages9
JournalAnnals of Internal Medicine
Volume152
Issue number5
StatePublished - Mar 2 2010

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ASJC Scopus subject areas

  • Internal Medicine

Cite this

Harvey, W. F., Yang, M., Cooke, T. D. V., Segal, N. A., Lane, N. E., Lewis, C. E., & Felson, D. T. (2010). Association of leg-length inequality with knee osteoarthritis a cohort study. Annals of Internal Medicine, 152(5), 287-295.