EFCAB14 and malnutrition: We added four exposure factors (nutritional anemias), semilunar cartilage resection (endoscopic resection of semilunar cartilage NEC), malnutrition (malnutrition), and excessive menstruation (excessive and frequent menstruation with regular cycle), and four MPs, MT-1F, ZNF 134, CAMK1D, and EFCAB14 were subjected to MVMR analysis to assess the direct effects of significant MPs on OA.