Leg length difference promotes knee arthritis

This study just published in the journal Annals of Internal Medicine made me want to slap my forehead in amazement at how long it takes common sense clinical experience to be absorbed into the mainstream. Here's the set-up for the investigation:

"Leg-length inequality is common in the general population and may accelerate development of knee osteoarthritis."

Their objective:

"To determine whether leg-length inequality is associated with prevalent, incident, and progressive knee osteoarthritis."

On a personal note, I have been 'lecturing' patients about this, and treating with good effect based on the sound physiology, for over 25 years. There is a tremendous biomechanical stress impact that batters the joints of the lower extremity and spine with a significant difference in leg length. What conclusion did the authors' data lead them to?

"Radiographic leg-length inequality was associated with prevalent, incident symptomatic, and progressive knee osteoarthritis. Leg-length inequality is a potentially modifiable risk factor for knee osteoarthritis."

Caution: treating this requires knowledge and experience because a clinically significant leg length inequality usually involves a combination of anatomical difference in the leg bones plus neuromuscular compensations. I find it takes a minimum of 3 weeks to verify the correctness of a therapeutic lift when combined with treatment that assists the body in making the numerous adjustments to the leg length correction.