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Bone marrow lesions are related to dynamic knee loading in medial knee osteoarthritis
  1. Kim L Bennell1,
  2. Mark W Creaby1,
  3. Tim V Wrigley1,
  4. Kelly-Ann Bowles1,
  5. Rana S Hinman1,
  6. Flavia Cicuttini2,
  7. David J Hunter3
  1. 1Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, University of Melbourne, Victoria, Australia
  2. 2Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
  3. 3Division of Research, New England Baptist Hospital, Massachusetts, USA
  1. Correspondence to Professor Kim L Bennell, School of Physiotherapy, University of Melbourne, Parkville, Victoria 3010, Australia; k.bennell{at}


Objectives To evaluate the relationship between mechanical loading, as indicated by the external knee adduction moment (KAM) during walking, and BML on MRI in people with medial knee osteoarthritis.

Methods Measures were taken in 91 individuals with medial knee osteoarthritis. Logistic regression analyses were performed with the presence/absence of medial tibial or medial femoral BML as the outcome and either peak KAM or KAM impulse as the independent variable. Analyses were also adjusted for age, gender, body mass index, alignment and walking speed.

Results In adjusted analyses, peak KAM was significantly related to medial tibial (OR 2.3; 95%CI 1.07 to 4.7), but not medial femoral (OR 1.85; 95%CI 0.93 to 3.7) BML. KAM impulse was significantly related to both medial tibial (OR 9.4; 95%CI 1.53 to 57.2) and medial femoral (OR 14.4; 95%CI 2.3 to 89.8) BML.

Conclusions The findings support the hypothesis that greater mechanical loading of the medial compartment plays a role in the pathogenesis of BML in medial tibiofemoral osteoarthritis.

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  • Funding This study was supported by funds received from a NHMRC project grant (#350297). The sponsors had no role in the study design, collection, analysis and interpretation of data, in writing the report or in the decision to submit the paper for publication.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of Melbourne, Human Research Ethics Committee.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.