Improvements in spinal alignment after high tibial osteotomy in patients with medial compartment knee osteoarthritis

Kim, Yoon Hyuk; Dorj, Ariunzaya; Han, Ah‐Reum; Kim, Kyung-Soo; Nha, Kyung Wook

doi:10.1016/j.gaitpost.2016.05.001

Cited by 13 publications

(8 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Following this surgery, FTA remains an index of good long-term surgical results 32,33 . Kim et al indicated that HTO improved SSA and spinal parameters significantly closer to that of healthy young subjects using surface body markers, and reduced abnormalities that may result in spinal problems, such as degeneration or pain 34 . Koshino et al reported that 1° of change in knee flexion was equal to about 0.1° of change in FTA.…”

Section: Discussionmentioning

confidence: 99%

Examination of the changes in lower extremities related to progression of adult spinal deformity: a longitudinal study of over 22 years

Shimizu

Kobayashi

Chiba³

et al. 2020

Sci Rep

View full text Add to dashboard Cite

this longitudinal observational study investigated the relationship between changes in spinal sagittal alignment and changes in lower extremity coronal alignment. A total of 58 female volunteers who visited our institution at least twice during the 1992 to 1997 and 2015 to 2019 periods were investigated. We reviewed whole-spine radiographs and lower extremity radiographs and measured standard spinal sagittal parameters including pelvic incidence [pi], lumbar lordosis [LL], pelvic tilt [pt], sacral slope [SS] and sagittal vertical axis [SVA], and coronal lower extremity parameters including femorotibial angle (ftA), hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDfA), mechanical medial proximal tibial angle (mMptA) and mechanical lateral distal tibial angle (mLDtA). Lumbar spondylosis and knee osteoarthritis were assessed using the Kellgren-Lawrence (KL) grading system at baseline and at final follow-up. We investigated the correlation between changes in spinal sagittal alignment and lower extremity alignment and changes in lumbar spondylosis. The mean age [standard deviation (SD)] was 48.3 (6.3) years at first visit and 70.2 (6.3) years at final follow-up. There was a correlation between changes in PILL and FTA (R = 0.449, P < 0.001) and between PILL and HKA (R = 0.412, P = 0.001). There was a correlation between changes in lumbar spondylosis at L3/4 (R = 0.383, P = 0.004) and L4/5 (R = 0.333, P = 0.012) and the knee joints. Changes in lumbar spondylosis at L3/4 and L4/5 were related to changes in KOA. Successful management of ASD must include evaluation of the state of lower extremity alignment, not only in the sagittal phase, but also the coronal phase. In recent years, with the aging population, the number of patients presenting to consultation rooms with both knee osteoarthritis (KOA) and lumbar degenerative diseases has increased 1. In adult patients with spinal deformity, spinal kyphosis changes are caused by disc degeneration and vertebral fracture. A previous study reported that spinal deformity in the sagittal phase is progressive, and influences pain, risk of falls, and health-related quality of life (HRQOL) 2-5. Barry et al. reported the compensatory mechanisms associated with adult spinal deformity, and reported that in advanced spinal deformity, the body is affected from head to toe, including changes in hip extension and knee flexion in the sagittal phase to maintain spinal alignment 6. On the other hand, KOA, which causes knee pain, knee contracture, decreased muscle strength, and decreased QOL, induced knee flexion in the sagittal phase and varus deformity in the coronal phase in the lower extremities, which is one of the characteristic changes proceeding KOA 7-9. Both the sagittal phase and the coronal phase are very important in the evaluation of KOA. Knee-spine syndrome has been previously reported by Murata et al. and Itoi who indicated that deformity of the knee joint influences spine deformity 10,11. However, their studies did not examine the coronal phase of

show abstract

Section: Discussionmentioning

confidence: 99%

Examination of the changes in lower extremities related to progression of adult spinal deformity: a longitudinal study of over 22 years

Shimizu

Kobayashi

Chiba³

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…However, there are some discrepancies in analyses about subjects, methodologies, and outcomes. Furthermore, the changes in gait could have diverse effects on the trunk, nonoperated limb, and hip and ankle joint in the operated limb after HTO [69]. Recent kinematical studies in gait are summarized in Table 3.…”

Section: Kinematicsmentioning

confidence: 99%

High Tibial Osteotomy: Review of Techniques and Biomechanics

Liu

Chen

Gao

et al. 2019

Journal of Healthcare Engineering

View full text Add to dashboard Cite

High tibial osteotomy becomes increasingly important in the treatment of cartilage damage or osteoarthritis of the medial compartment with concurrent varus deformity. HTO produces a postoperative valgus limb alignment with shifting the load-bearing axis of the lower limb laterally. However, maximizing procedural success and postoperative knee function still possess many difficulties. The key to improve the postoperative satisfaction and long-term survival is the understanding of the vital biomechanics of HTO in essence. This review article discussed the alignment principles, surgical technique, and fixation plate of HTO as well as the postoperative gait, musculoskeletal dynamics, and contact mechanics of the knee joint. We aimed to highlight the recent findings and progresses on the biomechanics of HTO. The biomechanical studies on HTO are still insufficient in the areas of gait analysis, joint kinematics, and joint contact mechanics. Combining musculoskeletal dynamics modelling and finite element analysis will help comprehensively understand in vivo patient-specific biomechanics after HTO.

show abstract

“…As the operated knee recurred to mild varus, the pelvis tended to align downward again; however, the final value did not decrease as far as the preoperative value and remained higher than the horizontal reference line [25]. These positive changes may have originated from the reported improvement of knee kinematics after OWHTO surgery, such as recovery of symmetry between the two legs [5, 3, 21].…”

Section: Discussionmentioning

confidence: 99%

Association of the joint line orientation angle of the contralateral limb with the alignment change of the unilateral and bilateral opening-wedge high tibial osteotomy

Park

Lee

2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose This study aimed to evaluate and compare unilateral and bilateral open-wedge high tibial osteotomy (OWHTO) using mid-term serial assessment of clinical and radiological outcomes, especially focussing on coronal lower extremity alignment. Methods Serial radiological assessments were performed in 40 patients (80 knees) with bilateral OWHTO and 49 patients (49 knees) with unilateral OWHTO. Both groups were further divided into four subgroups to compare each limb (unilateral involved and non-involved limbs and bilateral primarily and secondarily treated limbs). Radiological and clinical outcomes were evaluated and compared among the four groups. For the alignment change assessment, the pelvic tilt angle (PTA), weight-bearing line ratio (WBLR), joint line orientation angle (JLOA), medial proximal tibia angle (MPTA), joint line convergence angle (JLCA), distal tibia articular angle (DTAA), and talar inclination (TI) were measured pre-and postoperatively at 3, 6, and 12 months and annually thereafter. Student's t-test, one-way repeated-measures analysis of variance, and correlation analysis were used to compare the groups. Results Patients in the unilateral and bilateral OWHTO groups had similar postoperative radiological and clinical outcomes. Each unilaterally involved limb and primarily treated bilaterally involved limb were negatively afected by the contralateral limb with respect to increased JLOA during the postoperative period (unilateral OWHTO group: r = −0.350, p = 0.023; bilateral OWHTO group: r = −0.520, p = 0.005). The correction change of the ankle parameters in the secondarily treated limb showed greater varus alignment than the primarily treated limb after bilateral OWHTO (DTAA (0.1 ± 3.0 vs. -0.5 ± 3.8°, p = 0.014) and TI (0.9 ± 3.2° vs. -0.3 ± 2.9, p = 0.001)). Conclusion Unilateral and bilateral OWHTOs shared similar postoperative radiological and clinical outcomes. Alignment changes of the unilateral OWHTO and the primarily treated limb of the bilateral OWHTO were associated with the JLOA of the contralateral limb. Level of evidence Cohort study; Level III.

show abstract

Improvements in spinal alignment after high tibial osteotomy in patients with medial compartment knee osteoarthritis

Cited by 13 publications

References 29 publications

Examination of the changes in lower extremities related to progression of adult spinal deformity: a longitudinal study of over 22 years

Examination of the changes in lower extremities related to progression of adult spinal deformity: a longitudinal study of over 22 years

High Tibial Osteotomy: Review of Techniques and Biomechanics

Association of the joint line orientation angle of the contralateral limb with the alignment change of the unilateral and bilateral opening-wedge high tibial osteotomy

Contact Info

Product

Resources

About