Sagittal alignment of the spine-pelvis-lower extremity axis in patients with severe knee osteoarthritis

نویسندگان

  • W. J. Wang
  • F. Liu
  • Y.W. Zhu
  • M.H. Sun
  • Y. Qiu
  • W. J. Weng
چکیده

OBJECTIVES Normal sagittal spine-pelvis-lower extremity alignment is crucial in humans for maintaining an ergonomic upright standing posture, and pathogenesis in any segment leads to poor balance. The present study aimed to investigate how this sagittal alignment can be affected by severe knee osteoarthritis (KOA), and whether associated changes corresponded with symptoms of lower back pain (LBP) in this patient population. METHODS Lateral radiograph films in an upright standing position were obtained from 59 patients with severe KOA and 58 asymptomatic controls free from KOA. Sagittal alignment of the spine, pelvis, hip and proximal femur was quantified by measuring several radiographic parameters. Global balance was accessed according to the relative position of the C7 plumb line to the sacrum and femoral heads. The presence of chronic LBP was documented. Comparisons between the two groups were carried by independent samples t-tests or chi-squared test. RESULTS Patients with severe KOA showed significant backward femoral inclination (FI), hip flexion, forward spinal inclination, and higher prevalence of global imbalance (27.1% versus 3.4%, p < 0.001) compared with controls. In addition, patients with FI of 10° (n = 23) showed reduced lumbar lordosis and significant forward spinal inclination compared with controls, whereas those with FI > 10° (n = 36) presented with significant pelvic anteversion and hip flexion. A total of 39 patients with KOA (66.1%) suffered from LBP. There was no significant difference in sagittal alignment between KOA patients with and without LBP. CONCLUSIONS The sagittal alignment of spine-pelvis-lower extremity axis was significantly influenced by severe KOA. The lumbar spine served as the primary source of compensation, while hip flexion and pelvic anteversion increased for further compensation. Changes in sagittal alignment may not be involved in the pathogenesis of LBP in this patient population.Cite this article: W. J. Wang, F. Liu, Y.W. Zhu, M.H. Sun, Y. Qiu, W. J. Weng. Sagittal alignment of the spine-pelvis-lower extremity axis in patients with severe knee osteoarthritis: A radiographic study. Bone Joint Res 2016;5:198-205. DOI:10.1302/2046-3758.55.2000538.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Evaluation of Sagittal Spine-Pelvis-Lower Limb Alignment in Elderly Women with Pelvic Retroversion while Standing and Walking Using a Three-Dimensional Musculoskeletal Model

STUDY DESIGN In vivo biomechanical study using a three-dimensional (3D) musculoskeletal model for elderly individuals with or without pelvic retroversion. PURPOSE To evaluate the effect of pelvic retroversion on the sagittal alignment of the spine, pelvis, and lower limb in elderly females while standing and walking. OVERVIEW OF LITERATURE Patients with hip-spine syndrome have concurrent hi...

متن کامل

The Effect of Sagittal Femoral Bowing on the Femoral Component Position in Total Knee Arthroplasty

Background: In the current study, we investigated that how sagittal femoral bowing can affect the sagittal alignment ofthe femoral component in total knee arthroplasty (TKA).Methods: There were 25 patients underwent TKA. Long leg radiography in lateral view was performed. The sagittalfemoral bowing (SFB) and component alignment in relation to the sagittal mechanical axis and distal anterior cor...

متن کامل

بررسی نتایج درمانی واروس اسئوتومی دیستال فمور در 27 بیمار مبتلا به ژنوولگوم

Background: Genu valgum deformity is exaggerated valgus alignment of lower extremity mechanical axis in knee with a joint line that slopes superolaterally and is corrected by distal femoral osteotomy. In this study the results of treatment and satisfaction in patients with genu valgum were evaluated according to knee society score (KSS) and changes in pre-operation and post-operation lower extr...

متن کامل

Anatomical Alignment of Lower Extremity in Subjects With Genu Valgum and Genu Varum Deformities

Purpose: Changes in lower extremity alignment in individuals with abnormality of this segments are unclear. The present study aimed to compare lower extremity alignment in subjects with genu valgum and genu varum deformities and healthy subjects  in order to understand the lower extremity alignment changes in this group.  Methods: This was a causal-comparative study. The sample comprised 120 m...

متن کامل

The Effect of Total Knee Arthroplasty on Hindfoot Alignment in Patients with Severe Genu Varum and Genu Valgum

Background: The maintenance of deformity in the ankle and hindfoot after correction of knee deformity following kneearthroplasty may cause abnormal tension in the knee and patient dissatisfaction. The aim of this study was to determinethe effect of knee arthroplasty on the hindfoot alignment in patients with severe genu varum and valgum.Methods: A total of 84 patients with pri...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 5  شماره 

صفحات  -

تاریخ انتشار 2016