Hello,
As we see that unilateral knee osteoarthritis leads to over pressure on one side leg during walking and standing also. It may be affect the cartilage, meniscus, muscles, bone, proprioception just because of overloading on knee joint.
Its has a long term problem in contra-lateral knee joint or leg.
Evidences not clear that overloading may leads to knee OA and affect the proprioception.
I hope we can discuss this topic in detail and understand it properly
Thank You.
Hello.
May this article can help you
Article Leg Length Discrepancy and Osteoarthritis in the Knee Hip an...
Thanks Hassan for you suggestion.
But if there is not Leg Length Discrepancy than what are the changes occur in knee, hip & Lumber joint?
If we can see changes in health population than can we predict for early knee OA OR hip OA?
I think as per evidences , in normal limb alignment over planter pressure impact hardly leads to OA if other diagnosis like infective, inflammatory, trauma excluded. of course shape of foot wear can be affect.
Recent evidence shows that "Early knee osteoarthritis" poses a therapeutic dilemma to the musculoskeletal clinician. Despite the recent interest in arthroscopic and injectable regenerative therapies intended to repair or restore a focal target such as cartilage, meniscus, or subchondral bone, none have been shown to slow disease progression. A likely cause of these disappointing treatment outcomes is the failure to address chronic and excessive loading of the knee joint. A growing body of evidence suggests that first-line therapies for early knee osteoarthritis should emphasize unloading the knee joint since any potential therapeutic benefit of regenerative therapies will likely be attenuated by excessive mechanical demand at the knee joint. Minimally invasive medical devices such as patient-specific interpositional implants and extracapsular joint unloading implants are currently in development to address this clinical need.
Are You agree with this point or not?
Degeneration of a joint is multi-factorial. The repeated loads going through the joint is one factor. For example athletes even without history of injuries have the joints worn earlier that the same age individuals. Pathologies of neighbouring joints, as mal-rotations or valgus or varus positions can affect the knee (hip or ankle or even foot) as they result to abnormal loading of it. Pathologies of the spine can also affect it. Pathologies of the opposite side can also affect it, due to "sympathetic" overloading. Finally time is another factor, older generation people presenting degenerative joints (as the factors are acting on the joint longer and affect it).
I agree with Drs. Kelvin J. Murray and Michael F. Azari, when, in article “Leg length discrepancy and osteoarthritis in the knee, hip and lumbar spine” they say that “Furthermore, this link needs to be interrogated in adolescent populations to possibly prevent the develop-ment of OA later in life. If this cause-effect relationship is established by further research, interventional studies using heel-lifts, shoe lifts or other orthoses could be car-ried out to assess the value of this relatively simple and inexpensive measure in reducing OA’s burden of disease. This is a promising area of clinical research that may well have important public health implications”. In our experience with haemophilic children with repetitive haemarthrosis - Haemophilia (2006), 12, 140-146 - we observed that a few milimeters of LLD compensation on insoles contributed to avoid ankle instability avoiding other expontaneus haemarthrosis, so contributing to reduce the incidence of haemophilic arthropathy in the lower limbs joints.
I agree with Donaldo Jorge Filho comments. A longitudinal study following adolescents with leg length discrepancy, symptomatic and asymtomatic, treated with appropriate lifts is called for. Observe for common adolescent issues such as scoliosis, 'growing pains', IT band or patellar tendon syndromes and common athletic injuries such as knee and ankle strain/sprain, etc. Athletic participation should be noted but not required. Then, followed into adulthood, does the early application of compensatory lifts decrease the prevalence and/or severity of adult back or lower extremity arthritis? LLD often fluctuates during adolescence/growth so monitoring would be more frequent. Once growth plateaus, continuing to follow adults could be less frequent, with self-reporting of symptoms and frequency/consistency of shoe lift use. I work with older adults who may be aware of a LLD and say it never bothered them - but they now have arthritis or back pain that may be related. Correcting the LLD now may alleviate or prevent worsening of symptoms, but will not erase damage from years of maladaptive movement patterns.
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