Mechanical environment. Knee alignment has a strong impact on joint load distribution.11 Varus alignment is associated with progressive medial compartment OA (wearing of the medial meniscus) and valgus alignment with lateral compartment OA (wearing of the lateral meniscus); the degree of alignment correlates with the magnitude of the joint-space narrowing. People with varus knee alignment have a greater loss of function when walking than those with valgus alignment do.