ArticleBMC musculoskeletal disorders2018
Bone shape mediates the relationship between sex and incident knee osteoarthritis.
Article in BMC musculoskeletal disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
18 citing papers in PubMed, 28 citations in OpenAlex.
- Effect of 10.6-μm COJournal of orthopaedic surgery and research · 2023Trial
- Distal femoral morphology as a risk factor for osteoarthritis.Anatomical record (Hoboken, N.J. : 2007) · 2026Article
- Use of dual-energy X-ray absorptiometry to evaluate variation in bone shape and alignment associated with radiographic knee osteoarthritis: Findings from a study of 19,053 individuals in UK Biobank.Osteoarthritis and cartilage open · 2025Article
- Recent advances in osteoarthritis research: A review of treatment strategies, mechanistic insights, and acupuncture.Medicine · 2025Review
- Sexual dimorphism in peri-articular tissue anatomy - More keys to understanding sex-differences in osteoarthritis?Osteoarthritis and cartilage open · 2024Review
- Gender differences in patterns of cartilage loss: Data from the Osteoarthritis Initiative.Osteoarthritis and cartilage · 2024Observational
- Large-Scale Analysis of Meniscus Morphology as Risk Factor for Knee Osteoarthritis.Arthritis & rheumatology (Hoboken, N.J.) · 2023Article
- Cartilage thickness and bone shape variations as a function of sex, height, body mass, and age in young adult knees.Scientific reports · 2022Article
- A Machine Learning Model to Predict Knee Osteoarthritis Cartilage Volume Changes over Time Using Baseline Bone Curvature.Biomedicines · 2022Article
- Gender-Related Aspects in Osteoarthritis Development and Progression: A Review.International journal of molecular sciences · 2022Review
- Epidemiology of osteoarthritis.Osteoarthritis and cartilage · 2022Review
- Assessment of morphological differences of the proximal tibia in healthy knees: analysis of the 3-dimensional mathematical model.Quantitative imaging in medicine and surgery · 2021Article
- Novel nomogram for predicting the progression of osteoarthritis based on 3D-MRI bone shape: data from the FNIH OA biomarkers consortium.BMC musculoskeletal disorders · 2021Article
- The Genetic Epidemiology of Joint Shape and the Development of Osteoarthritis.Calcified tissue international · 2021Review
- Common Biochemical and Magnetic Resonance Imaging Biomarkers of Early Knee Osteoarthritis and of Exercise/Training in Athletes: A Narrative Review.Diagnostics (Basel, Switzerland) · 2021Review
- Long wait times for knee and hip total joint replacement in Canada: An isolated health system problem, or a symptom of a larger problem?Osteoarthritis and cartilage open · 2021Article
- The optimisation of deep neural networks for segmenting multiple knee joint tissues from MRIs.Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society · 2020Article
- Patterns of Change Over Time in Knee Bone Shape Are Associated with Sex.Clinical orthopaedics and related research · 2020Observational
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundKnee bone shape differs between men and women and the incidence of knee osteoarthritis (OA) is higher in women than in men. Therefore, the purpose of the present study was to determine whether the observed difference in the incidence of knee radiographic OA (ROA) between men and women is mediated by bone shape.
methodsWe randomly sampled 304 knees from the OAI with incident ROA (i.e., development of Kellgren/Lawrence grade ≥ 2 by month 48) and 304 knees without incident ROA. We characterized distal femur and proximal tibia shape on baseline radiographs using Statistical Shape Modeling. If a specific bone shape was associated with the risk of incident ROA, marginal structural models were generated to assess the mediation effect of that bone shape on the relation of sex and risk of incident knee ROA adjusting for baseline covariates.
resultsCase and control participants were similar by age, sex and race, but case knees were from higher body mass index (BMI) participants (29.4 vs. 27.0; p < 0.001). Women had 49% increased odds of incident knee ROA compared with men (adjusted odds ratio (OR) = 1.49, 95% Confidence Interval (C.I.): 1.04, 2.12). There was an inconsistent mediation effect for tibial mode 2 between sex and incident knee ROA, with an indirect effect OR of 0.96 (95% C.I.: 0.91-1.00) and a direct effect OR of 1.56 (95% C.I.: 1.08-2.27), suggesting a protective effect for this mode. Similar findings were also observed for the mediation effect of tibia mode 10 and femur mode 4. These shape modes primarily involved differences in the angular relation of the heads to the shafts of the femur and tibia.
conclusionsDistal femur and proximal tibia bone shapes partially and inconsistently mediated the relationship between sex and incident knee OA. Women had a higher risk of incident ROA, and specific bone shapes modestly protected them from even higher risk of ROA. The clinical significance of these findings warrant further investigation.
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