scholarly journals Changes in Coronal Alignment of the Knee Joint after Supramalleolar Osteotomy

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Dong-Il Chun ◽  
Jahyung Kim ◽  
Sung Hun Won ◽  
Jaeho Cho ◽  
Jeongku Ha ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Knee Joint ◽  
Ankle Joint ◽  
Lower Limb ◽  
Varus Deformity ◽  
Limb Alignment ◽  
Coronal Alignment ◽  
Lower Limb Alignment ◽  
Radiographic Parameters ◽  
Supramalleolar Osteotomy

Background. Assessing knee joint orientation changes after SMO may help clinical advancement in managing patients with ipsilateral ankle and knee joint arthritis. However, knee joint changes after supramalleolar osteotomy (SMO) have not been reported. We investigated changes in coronal alignment of the knee joint after SMO. Methods. In this multicentre study, from January 2014 to December 2018, 47 ankles with varus osteoarthritis treated with SMO were retrospectively identified. Ankle joint changes were assessed using the tibiotalar angle, talar tilt angle, and lateral distal tibial angle (LDTA); knee joint changes using the medial proximal tibial angle (MPTA), medial and lateral joint space widths (mJSW and lJSW, respectively), and medial and lateral joint line convergence angles (JLCA); and lower limb alignment changes using mechanical axis deviation angle (MADA) and the hip-knee-ankle (HKA) angle measured on full-length anteroposterior radiographs of the lower extremity. Correlation analysis and binary logistic regression analysis were performed. Results. Postoperatively, LDTA ( p < 0.001 ) and tibiotalar angle ( p < 0.001 ) significantly changed, indicating meaningful improvement in the ankle joint varus deformity. Regarding the knee joint changes, JLCA significantly changed into valgus direction ( p = 0.044 ). As for lower limb alignment changes, MADA significantly decreased ( p < 0.001 ), whereas the HKA angle significantly increased ( p < 0.001 ). In univariate and multivariate logistic regression analyses, changes in the MADA ( p < 0.001 ) and the HKA angle ( p < 0.001 ) were significantly correlated with the correction angle. Conclusions. SMO remarkably improves ankle joint varus deformity, followed by significant lower limb alignment changes. Despite meaningful changes in JLCA, the relationship between the amount of osteotomy near the ankle joint and improvement in knee joint radiographic parameters was not significant. Radiographic parameters of the knee joint would less likely be changed following SMO.

scholarly journals Effects of Total Knee Arthroplasty on Coronal and Sagittal Whole-Body Alignments: Serial Assessments Using Whole-Body EOS

2021 ◽  
Vol 10 (15) ◽  
pp. 3242
Author(s):  
Seong-Chan Kim ◽  
Han-Gyeol Choi ◽  
Joo-Sung Kim ◽  
Tae-Woo Kim ◽  
Yong-Seuk Lee
Keyword(s):  
Knee Joint ◽  
Lower Limb ◽  
Weight Bearing ◽  
Whole Body ◽  
Limb Alignment ◽  
Lower Limb Alignment ◽  
Passive Motion ◽  
X Ray ◽  
Spinopelvic Alignment ◽  
Total Knee

Background: The aims of this study were to evaluate the effects of correcting lower limb alignment by total knee arthroplasty (TKA) on the spinopelvic alignment and to identify patients with difference in the knee joint between clinically measured passive motion and the actual standing posture. Methods: In this retrospective study, 101 patients who underwent TKA and whose serial whole-body EOS X-ray were available were included. The relationship of the knee and spinopelvic alignment was analyzed by evaluating the parameters of standing anterior-posterior and lateral whole-body EOS X-ray. The differences between postoperative passive motion and weight-bearing posture in the knee joint were assessed in both coronal and sagittal planes. Furthermore, the causes of such differences were analyzed. Results: Significant correlations between Δpelvic obliquity and coronal ΔHip-Knee-Ankle (HKA)Rt-Lt angle between the preoperative and 3-month and 1-year postoperative data (p < 0.001 and p < 0.005, respectively) and improved with coronal lower limb alignment close to neutral resulted in decreased pelvic obliquity (p < 0.001, ß = 0.085 and p = 0.005, ß = 0.065, respectively) were observed. The correlations between Δpelvic tilt (PT) and Δsacral slope (SS) and sagittal ΔHKARt-Lt angle were statistically significant (PT: p < 0.001 and p < 0.045; SS: p = 0.002 and p < 0.001, respectively). The improved sagittal alignment close to neutral resulted in decreased PT and increased SS. The difference between postoperative passive motion and the weight-bearing posture of the knee joint was correlated with lumbar lordosis and sagittal C7 plumb line-sacrum distance (p = 0.042 and p < 0.001, respectively). Conclusions: The correction of lower limb alignment with TKA affected pelvic parameters dominantly; however, there was little effect on the spinal alignment. Additionally, patients with anterior stooping or lumbar flat back demonstrated difference in extension between passive knee motion and standing. Therefore, rather than only focusing on changes in the knee alignment correction, knee surgeons should also evaluate the spinopelvic alignment before surgery to consider the prognosis of the standing and predict the possible changes in the whole-body alignment. This preoperative assessment may improve the prognosis of TKA.

scholarly journals Spinal Flexibility Is an Important Factor for Improvement in Spinal and Knee Alignment after Total Knee Arthroplasty: Evaluation Using a Whole Body EOS System

2020 ◽  
Vol 9 (11) ◽  
pp. 3498
Author(s):  
Seong Chan Kim ◽  
Joo Sung Kim ◽  
Han Gyeol Choi ◽  
Tae Woo Kim ◽  
Yong Seuk Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Lower Limb ◽  
Whole Body ◽  
Limb Alignment ◽  
Lower Limb Alignment ◽  
Spinal Flexibility ◽  
Flexion Extension ◽  
Total Knee

The purposes of this study were (1) to evaluate the relationship between lumbosacral flexibility and the effects of total knee arthroplasty (TKA) on whole-body alignment; and (2) to determine the prerequisites of the adjacent joints for successful TKA. A total of 116 patients (156 cases) who had whole-body X-ray and flexion-extension lumbar radiograph available were enrolled. For the sagittal alignment evaluation, hip–knee–ankle (HKA) angle, pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), and C7 plumb line-sacrum distance (SVA) were evaluated on the whole-body radiographs. Lumbar flexibility (LF) was evaluated using the flexion-extension lumbar radiographs, and pelvic flexibility (PF) was evaluated using the pelvic incidence (PI). The disparities in the knee joint between postoperative passive motion and weight-bearing posture were assessed. LF was significantly correlated with ΔLL and ΔSVA (LL: p = 0.039, SVA: p = 0.040; Pearson correlation coefficient (PCC): −0.206 and 0.205, respectively). There were correlations between PF and ΔSS (p < 0.001, PCC: −0.362), and between the disparity and LF (p = 0.005, PCC = −0.275). Linear regression analysis demonstrated that LF was significantly associated with the presence of disparity (p = 0.005, β = −0.205). LF is an important factor for improved spinal and lower limb alignment after TKA. Additionally, reduced LF may result in knee joint disparity between passive extension and standing extension status. Therefore, surgeons should consider spinopelvic alignment, including lower limb alignment preoperatively, to be able to predict possible changes in whole-body alignment following TKA.

Effects of an intentional gait modification on lower limb alignment

2017 ◽  
Vol 61 (1) ◽  
pp. 936-939
Author(s):  
Seobin Choi ◽  
Gwanseob Shin
Keyword(s):  
Knee Joint ◽  
Lower Limb ◽  
Compressive Force ◽  
Meniscus Tear ◽  
Limb Alignment ◽  
Lower Limb Alignment ◽  
Positive Effects ◽  
Medial Side ◽  
Peak Knee ◽  
Gait Modification

Construction workers are exposed to the risk of medial meniscus tear due to their repetitive kneeling posture. Injury prevention requires the reduction of compressive force on the medial side of the knee joint by reducing knee adduction angle. The objective of this experimental study was to explore whether an intentional gait modification could change the lower limb alignment and reduce the knee adduction angle without any brace or external devices. Eight healthy participants walked on a treadmill with three different gait strategies: normal, valgus and varus walking. Their lower limb kinematics data were captured by three-dimensional motion capture system, and knee joint adduction angle variables were compared between the three strategies. Results found significant (p<0.05) decrease of the peak knee adduction angle during stand and swing phases when walking with intentional valgus strategy compared to when walking normally, indicating the positive effects of gait modification on the lower limb alignment.

scholarly journals Osteoarthritic and non-osteoarthritic patients show comparable coronal knee joint line orientations in a cross-sectional study based on 3D reconstructed CT images

2021 ◽  
Author(s):  
Silvan Hess ◽  
Lukas B. Moser ◽  
Emma L. Robertson ◽  
Henrik Behrend ◽  
Felix Amsler ◽  
...  
Keyword(s):  
Lower Limb ◽  
Joint Line ◽  
Line Orientation ◽  
Published Data ◽  
Detailed Knowledge ◽  
Limb Alignment ◽  
Coronal Alignment ◽  
Lower Limb Alignment ◽  
Cross Sectional ◽  
Mean Values

Abstract Purpose Recently introduced total knee arthroplasty (TKA) alignment strategies aim to restore the pre-arthritic alignment of an individual patient. The native alignment of a patient can only be restored with detailed knowledge about the native and osteoarthritic alignment as well as differences between them. The first aim of this study was to assess the alignment of a large series of osteoarthritic (OA) knees and investigate whether femoral and tibial joint lines vary within patients with the same overall lower limb alignment. The secondary aim was to compare the alignment of OA patients to the previously published data of non-OA patients. This information could be useful for surgeons considering implementing one of the new alignment concepts. Material Coronal alignment parameters of 2692 knee OA patients were measured based on 3D reconstructed CT data using a validated planning software (Knee-PLAN®, Symbios, Yverdon les Bains, Switzerland). Based on these measurements, patients' coronal alignment was phenotyped according to the functional knee phenotype concept. These phenotypes represent an alignment variation of either the overall alignment, the femoral joint line orientation or the tibial joint line orientation. Each phenotype is defined by a specific mean and covers a range of ± 1.5° from this mean. Mean values and distribution among the phenotypes are presented and compared between two populations (OA patients of this study and non-OA patients of a previously published study) as well as between HKA subgroups (varus, valgus and neutral) using t tests and Chi-square tests (p < 0.05). Results Femoral and tibial joint lines varied within patients with the same overall lower limb alignment. A total of 162 functional knee phenotypes were found (119 males, 136 females and 94 mutual phenotypes). Mean values differed between the OA and non-OA population, but differences were small (< 2°) except for the overall alignment (e.g. HKA). The distribution of OA and non-OA patients among the phenotypes differed significantly, especially among the limb phenotypes. Conclusion Differences between OA and non-OA knees are small regarding coronal femoral and tibial joint line orientation. Femoral and tibial joint line orientation of osteoarthritic patients can, therefore, be used to estimate their native coronal alignment and plan an individualized knee alignment. Level of clinical evidence III.

scholarly journals KINANTHROPOLOGICAL ANALYSIS OF THE CORE

2020 ◽  
pp. 335
Author(s):  
Strahinja Nikolić ◽  
Zlatko Ahmetović ◽  
Zoran Đokić
Keyword(s):  
Lower Limb ◽  
Scientific Journal ◽  
Lumbar Region ◽  
Sports Performance ◽  
Journal Articles ◽  
Limb Alignment ◽  
Lower Limb Alignment ◽  
The Core ◽  
Morphological Status ◽  
Lumbar Stabilization

The aim of this research is to investigate existing research dealing with the topic of the structure, functional and morphological status of the muscles that make up the body's core, as well as how improving the core affects the advancement of sports technique and its efficiency. The term core most commonly refers to the trunk, or more precisely, to the lumbar region. Core muscles play a significant role in lower limb alignment and stability, associated with poor alignment and injuries. The development of the core strength to improve the efficiency of sports performance is a controversial issue that has yielded different results. The analysis of the scientific journal articles revealed that the specificity of the program for increasing lumbar stabilization with the appropriate sport or skill is of the utmost importance. Therefore, it is necessary to specialize training facilities so that they are suited to a specific sport branch or discipline.

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