A radiographic analysis of alignment of the lower extremities – initiation and progression of varus-type knee osteoarthritis

Matsumoto, Tomoyuki; Hashimura, Masataka; Takayama, Koji; Ishida, Kazunari; Kawakami, Yoshiyuki; Matsuzaki, Takashi; Nakano, Nobuaki; Matsushita, Takehiko; Kuroda, Ryosuke; Kurosaka, Masahiro

doi:10.1016/j.joca.2014.11.015

Cited by 112 publications

(120 citation statements)

References 27 publications

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“…In patients with knee OA, varus alignment is caused by a more medial inclination of the tibial plateau and reduced valgus angulation of the distal femur compared to what is seen in healthy individuals. In addition, Matsumoto et al . found that the femur shifts from a medially bowed curvature to a laterally bowed arrangement with age.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Compartment Involvement in End‐stage Knee Osteoarthritis in a Chinese Orthopedic Center: Implications for Implant Choice

Sun

Palmer

Liu

et al. 2018

Orthopaedic Surgery

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Section: Discussionmentioning

confidence: 99%

Patterns of Compartment Involvement in End‐stage Knee Osteoarthritis in a Chinese Orthopedic Center: Implications for Implant Choice

Sun

Palmer

Liu

et al. 2018

Orthopaedic Surgery

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“…The multiple regression analyses were done first with a crude model, which was then adjusted for age (continuous), sex (0: male, 1: female), and BMI (continuous) for adjusted model. These covariates were chosen because they might be associated with the alterations of the frontal plane knee alignment and foot posture and not on the causal pathway [11, 43, 44]. …”

Section: Measurementsmentioning

confidence: 99%

Association of frontal plane knee alignment with foot posture in patients with medial knee osteoarthritis

Ohi

Iijima

Aoyama

et al. 2017

BMC Musculoskelet Disord

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BackgroundTo examine the association of radiographic frontal plane knee alignment with three-dimensional foot posture in patients with medial knee osteoarthritis (OA).MethodsParticipants in orthopedic clinics with Kellgren/Lawrence (K/L) grade ≥1 (88 patients and 88 knees; age, 61–91 years; 65.9% female) were enrolled. An anteroposterior radiographic view was used to assess the anatomical axis angle (AAA) after subtracting a sex-specific correction factor. The three-dimensional foot posture was also evaluated.ResultsMultiple regression analyses showed that increased corrected AAA (i.e., valgus direction) was independently associated with a decrease in the hallux valgus angle (regression coefficient: −0.40 per degree, 95% confidence interval [CI]: −0.72, −0.09; P = 0.013) and increase in the pronation angle of the calcaneus relative to floor (regression coefficient: 0.33 per degree, 95% CI: 0.10, 0.56; P = 0.005) adjusted for age, sex, and body mass index. The relationship between the corrected AAA and hallux valgus angle strengthened (regression coefficient: −0.60 per degree, 95% CI: −1.08, −0.13; P = 0.014) in varus-aligned knees examined separately (63 knees). The other foot postures (navicular height, navicular height/foot length, and rearfoot angle) were not significantly associated with corrected AAA.ConclusionsRadiographic frontal plane knee alignment was associated with hallux valgus angle and calcaneus angle relative to the floor in patients with medial knee OA, particularly in varus-aligned knees. These results indicate a connection between altered frontal knee alignment and foot posture, which may be helpful in understanding the pathogenesis of altered foot posture observed in patients with knee OA.

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“…Therefore, it is probably not affected to the non-dominant side of the leg. The main effects of lateral wedges were reductions of external knee adduction moment and of the knee adduction angular impulse [3,36], and the lateral wedge insole shifted the weight bearing line from medial to the middle of the knee joint [6]. Therefore, this structural change may affect changes of muscle activation around the thigh muscle, and pelvic stability might be increased by co-contraction of the hamstring and quadriceps muscles.…”

Section: Discussionmentioning

confidence: 99%

“…Genu valgum and genu varum are commonly reported as knee joint deformities [1]. Genu varum has been previously shown to increase the risk of osteoarthritis [2] and genu varum is common in osteoarthritis, because knee osteoarthritis more often affects the medial than the lateral compartment [3]. In bilateral standing with normal knee alignment, the weight-bearing line of the lower extremity passes through the center of the knee joint, thus the weight is distributed to the middle of the knee joint [4,5].…”

Section: Introductionmentioning

confidence: 99%

The immediate effects of foot pressure based insole on ankle dorsiflexion range of motion, postural sway, and muscle activation in healthy adults with genu varum

Chun

Lee

2018

PTRS

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The purpose of this research was to determine the immediate effects of wearing a foot-pressure-based insole (FPBI) on ankle dorsiflexion range of motion (DFROM), postural sway, and muscle activation in healthy individuals with genu varum. Design: Cross-sectional study. Methods: This study was conducted on thirteen adults, with six male and seven females subjects. The mean age was 24.08 years. Foot pressure was measured to apply the FPBI and the weight bearing lunge test was performed with the application of a flat insole (FI) and FPBI. Examination was randomly performed in four conditions to measure both postural sway and muscle activation. All participants applied both the FI and FPBI with four conditions. The four conditions were as follows: 1) Romberg test posture with eyes closed, 2) Romberg test posture with eyes opened, 3) dominant single leg standing with eyes opened, and 4) non-dominant single leg standing with eyes opened. Results: For ankle DFROM between the FI and FPBI, a significant increase was observed in both the dominant and non-dominant leg (p<0.05). For postural sway between the FI and FPBI in the Romberg test posture with eyes closed and dominant single leg standing with eyes opened conditions, a significant decrease was observed (p<0.05). However, the postural sway between FI and FPBI in the Romberg test posture with eyes opened and non-dominant single leg standing with eyes opened, no significant decrease was observed. Also, there were no significant effects on muscle activation between the application of the FI and FPBI. Conclusions: The result showed that FPBI immediately improved ankle DFROM and postural sway. It seems that FPBI may improve genu varum in healthy individuals with genu varum.

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A radiographic analysis of alignment of the lower extremities – initiation and progression of varus-type knee osteoarthritis

Cited by 112 publications

References 27 publications

Patterns of Compartment Involvement in End‐stage Knee Osteoarthritis in a Chinese Orthopedic Center: Implications for Implant Choice

Patterns of Compartment Involvement in End‐stage Knee Osteoarthritis in a Chinese Orthopedic Center: Implications for Implant Choice

Association of frontal plane knee alignment with foot posture in patients with medial knee osteoarthritis

The immediate effects of foot pressure based insole on ankle dorsiflexion range of motion, postural sway, and muscle activation in healthy adults with genu varum

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