Knee pain from osteoarthritis (OA) tends to be poorly correlated to degree of cartilage loss. Other factors related to knee OA, including bone marrow edema and synovitis, may be more proximal determinants of pain in knee OA. Synovitis is usually quite limited in knee OA and difficult to quantify on physical exam. Magnetic resonance (MR) imaging is a more sensitive technique for assessing synovitis in knee OA.
Despite its prevalence, no effective pharmacotherapies have been definitively proven to modify the course of radiographic knee osteoarthritis (OA). Risedronate, a bisphosphonate that reduces bone turnover, has been shown in animal models to inhibit cartilage degradation and progression of disease.
Mechanical forces exerted on the knee contribute to the development of knee osteoarthritis (OA). Among these, the additional torque about the knee associated with increasing leg length may predispose people of taller stature to knee OA. However, this association has received little prior investigation. In contrast to body height, which may decrease with age, knee height is relatively constant, making knee height a more appropriate surrogate for stature in the elderly.
Increased body weight is thought to increase the risk of knee osteoarthritis (OA) by increasing the amount of mechanical knee loading subjected to the knees with use. Accordingly, obesity is a well-established risk factor for the development of knee OA. However, weight alone may not completely identify risk, as body weight reflects distribution of body composition (adipose, lean tissue mass, and bone mass) that may differ between individuals and convey differing risk patterns for knee OA.