Hello

According to the question two terms we need to understand. First is asymmetrical and second is bilateral. Here both knees are involved but the symptoms and the degenerative changes are different. The timing of involvement is also different.

Now the question is what may be the causes?? Here are the points to be considered:

1. Asymmetrical loading of body

2. Asymmetrical posture or weight transfer of body during locomotion or static activities

Since knee joint is a weight-bearing joint, asymmetrical weight transfer may lead to wear and tear in that particular knee which is more involved. And after the involvement or degenerative changes the other knee is being stressed due to body's protective phenomenon. Hence, there is asymmetrical degenerative changes and bilaterally involvement occurs.

Regards

NR Mohanty

One possible cause are micro-projections of subcondylar bone at the interface with the articular cartilages. These projections concentrate stress and can lead to anomalies of the joint. They are formed during development with no particular anatomical plan, and will be different between knees. The medical community does not see them because they are too small to be imaged by clinical CT.

In coaching, it’s also called overuse injury; Soccer players, for example, may involve many repetitous activities favoring a tendency to play mostly with one foot deemed stronger or more precise. The opposite foot is then not developed with the same stressors applied symmetrically to the system: Excessive and differing knee strain is thus applied to both planting foot knee and kicking foot knee, with subsequent degenerative changes over time as Mohanty points out.

In my experience, I observed , on the dominant side a higher degree of overuse. I think, also the dominant side can be more exposed to thrauma.

Hello

Medial knee osteoarthritis is the usual form, if there is asymmetry it is because a knee was subjected to evolutionary or traumatic problems

There is a deformity called 'wind swipe'. One knee is varus and other is valgus deformed.

The reason is as already told asymmetric loading.

Never in my professional life as an orthopedist I saw that modality.congenital wind swipe , that is described, excuse me.

In my view the reason of developing asymmetrical OA at knee joint is unequal weight distribution on both legs .kinesthetic and postural education should be added in Rehabilitation management.