McKenzie White

All Publications

• BMI and Varus Malalignment Compound to Define a High-Risk Phenotype for Compartment-Specific Knee Osteoarthritis Progression. medRxiv : the preprint server for health sciences White, M. S., Kogan, F., Delp, S. L., Chu, C. R., Sherman, S. L., S, A. P., Gold, G. E., Chaudhari, A. S., Gatti, A. A. 2026

  Abstract

  Knee osteoarthritis (KOA) is a leading cause of disability, yet which patients will experience structural decline remains unclear. Body mass index (BMI) and lower limb alignment are established risk factors for KOA, but their independent and interactive effects on compartment-specific cartilage loss and total knee replacement (TKR) have not been characterized at scale.We analyzed 5,832 limbs from 3,016 participants in the Osteoarthritis Initiative followed over 7 years. Cartilage thickness in the weight-bearing medial and lateral femur and tibia was quantified, and lower limb alignment was measured using hip-knee-ankle (HKA) angle obtained from full-limb radiographs. Linear mixed-effects models estimated the independent and interactive effects of BMI and lower limb alignment on longitudinal cartilage thinning, and mixed-effects logistic regression modeled TKR risk.In the medial compartment, BMI and varus alignment interacted multiplicatively, with their combined effect exceeding the sum of independent contributions (femur: p = 0.011; tibia: p< 0.001). At +10kg/m2 BMI and +10° varus, the rate of medial femur cartilage thinning was 243.5% faster than the reference rate. In the lateral compartment, BMI and valgus alignment were independently associated with faster cartilage thinning, with no significant interaction. TKR risk increased exponentially with HKA deviation (odds ratio [OR] = 1.38 per 1°; ~five-fold at 5° malalignment) but was not associated with BMI.BMI and lower limb alignment influence structural KOA progression through compartment-specific pathways. The multiplicative interaction in the medial compartment identifies high BMI combined with varus malalignment as a discrete high-risk phenotype, with implications for clinical risk stratification and disease-modifying intervention design.

  View details for DOI 10.64898/2026.04.15.26350819

  View details for PubMedID 42064958

  View details for PubMedCentralID PMC13127543

• Osteoarthritis year in review 2025: Imaging. Osteoarthritis and cartilage Harkey, M. S., Gatti, A. A., Jansen, M. P., White, M. S., Tolzman, J., Parmar, A., Frederick, I., Link, T. M., Hart, H. F. 2025

  Abstract

  To conduct a narrative review of selected imaging studies published in the past year, with a focus on how emerging methods and multi-tissue assessments are contributing to disease characterization, early detection, and intervention strategies.We conducted a comprehensive search strategy of PubMed, Embase, and CINAHL for original English-language human studies on imaging in osteoarthritis, published between March 2024 and March 2025. From the 262 full-text studies that met inclusion criteria, we identified a set of representative studies through independent review and group discussion. These studies are organized into five themes that emerged from this study: effusion-synovitis, infrapatellar fat pad, muscle, subchondral bone, and subcutaneous fat. Within each theme, one highlighted study and several additional studies were synthesized, followed by a summary of cross-cutting insights and future directions.A total of 26 studies were included. Collectively, the studies reinforce the importance of viewing osteoarthritis as a condition involving multiple joint structures, with inflammation as a recurring feature across tissues. Muscle quality and local adiposity emerged as consistent imaging biomarkers, while accessible tools such as ultrasound and AI-enhanced radiography demonstrated potential for scalable clinical application. Links between imaging findings and biomechanics, particularly gait and loading patterns, also featured prominently. Cross-cutting themes emphasized the value of considering multiple tissues, expanding the reach of imaging to clinical and community settings, and integrating imaging with functional measures.Imaging research in the osteoarthritis continues to broaden in scope and application. The studies highlighted in this review illustrate how advances in methods and metrics are improving opportunities for earlier detection, more precise assessment of symptoms, and the development of targeted, structure-informed interventions.

  View details for DOI 10.1016/j.joca.2025.11.004

  View details for PubMedID 41241372