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Pain and varus thrust in OA knee

Issue 37 Synovium (Autumn 2012)

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We have seen above that assessment of the painful knee using imaging is problematical. A small study published in Arthritis & Rheumatism1 suggests that a clinical assessment of varus thrust during gait may help in directing treatment. In a small subset of patients (82) enrolled in a larger study of vitamin D treatment for OA knee, knee varus thrust (defined as the first appearance or worsening of varus during ambulation) was associated with higher pain scores. Abnormalities of static alignment on radiographic assessment were not associated with higher pain scores. Further evaluation of this observation in larger studies is needed to confirm this association before recommendation of measures to control or correct varus thrust (we presume with bracing), but this study suggests a positive line of enquiry that may lead to treatment that satisfies Synovium criteria for treatment of OA knee – simple, safe, cost-effective and ideally self-administered. 

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