Associations between Hormonal and Mechanical Factors of Knee Osteoarthritis in Women—A Preliminary Study

David S. Mandeville, Gretchen A. Casazza, Andrea C. Alvarez, Julia Sheremet, Brandee L. Waite, Brian A. Davis

Department of Kinesiology and Health Science, California State University, Sacramento, USA.
Department of Physical Therapy, California State University, Sacramento, USA.
Sports Medicine Program, University of California, Davis Health System, Sacramento, USA.

DOI: 10.4236/ojra.2013.32012                

Abstract

The purpose of this study was to determine the associations between urinary estradiol (E₂) metabolite concentration and medial knee loading with radiographic disease severity in middle aged women with initial stage knee osteoarthritis (OA). Women presenting with knee pain were recruited into a cross-sectional correlation study (KOA, n = 9, age = 52 ± 4 yrs). Self report menstrual history, the Modified Baecke Questionnaire and the Knee Injury and Osteoarthritis Outcome Score (KOOS) subjective data were collected. A fasting blood sample (follicle stimulating hormone (FSH) and Tumor Necrosis Factor-α (TNF-α)), and urine catch (16α-hydroxyestrone and 2-hydroxyestrone) were collected. Gait analysis using an 8-camera motion analysis system assessed internal knee varus moment and foot progression angle. Pearson Product moments tested for associations between urinary 16α-hydroxyestrone and 2-hydroxyestrone, TNF-α, medial knee loading, and radiographic disease severity (Kellgren/Lawrence (K/L) radiographic score). Significant correlations were found within the hormonal biomarkers (r = 0.94, p < 0.001) and within the biomechanical markers (r = 0.76, p < 0.02), but not between hormonal and biomechanical variables (r = 0.39, p = 0.31). No correlations were found for radiographic disease severity or TNF-α. The lack of association between hormonal and biomechanical variables could be due to large variability of the E₂ metabolites seen in the menopause transition and the limited structural changes of initial staged knee OA.

Keywords

Knee Osteoarthritis; 2-Hydroxyestrone; Follicle Stimulating Hormone; Gait Analysis; Medial Knee Loading; Tumor Necrosis Factor-α

Conflicts of Interest

The authors declare no conflicts of interest.

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