Medial and lateral osteoarthritis of the knee is related to variations of hip and pelvic anatomy

Weidow, Jonas; Mars, I.; Kärrholm, Johan

doi:10.1016/j.joca.2005.01.009

Cited by 46 publications

(42 citation statements)

References 16 publications

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“…We previously found that these patients had a broader pelvis than controls and medial OA patients. 27 Lateral OA was also associated with a steeper angle of the femoral neck (coxa valga) on the AP view, which could be due to more anteversion or increased external femoral rotation as observed in this dynamic study. This femoral deformity, which might compensate for a wider pelvis, might have developed during growth because of muscular imbalance or acetabular dysplasia.…”

Section: Discussionsupporting

confidence: 58%

“…Presence of hip disease may be another reason. In a previous study of lateral knee OA patients, 27 we observed that as many as half of the cases also had OA of the hip, which will impair hip extension.…”

Section: Discussionmentioning

confidence: 67%

“…In our study, not only were expected differences of knee angles and moments observed in the frontal plane, but diverging patterns of femoral and tibial rotations were also recorded. These changes can be explained by specific anatomy of the pelvis and hip observed in lateral OA patients, 27 but this hypothesis needs verification in further studies.…”

Section: Discussionmentioning

confidence: 96%

“…Because of female dominance among patients with lateral OA, we restricted our study to females. Radiographic observations of shorter femoral neck-and-head shaft distance 27 could also indicate increased external hip rotation compared to normals, with less abduction and decreased internal abduction moments. In patients with medial OA, who had increased femoral offset compared to controls, we did not expect to find any corresponding changes.…”

Section: Introductionmentioning

confidence: 99%

“…27 In this study, we determined if these differences affected the kinematics and kinetics of the hip and the knee. In addition, a control group without any known musculoskeletal disease was studied.…”

Section: Introductionmentioning

confidence: 99%

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Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: Gait analysis of 30 patients and 15 controls

et al. 2006

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The motions and moments in the hip and knee in female patients on the waiting list for knee prosthesis surgery with medial (n ¼ 15) or lateral (n ¼ 15) osteoarthritis (OA) were compared with a control group (n ¼ 15). We hypothesized that not only the kinematics and kinetics of the knee but also of the hip would differ between patients the medial and lateral groups. At midstance, patients with lateral OA showed slightly (28) more maximal (peak) adduction ( p ¼ 0.015) of the hip joint and patients with medial OA had 78 more abduction (p < 0.001) than did controls. In patients with lateral OA, the femur was positioned in about 78 more maximum external rotation (p ¼ 0.001), but femur position did not differ between medial OA and controls ( p ! 0.8). There was a tendency to higher internal hip rotation moment in lateral OA compared to controls ( p ¼ 0.021). The maximum values of the internal knee abduction moments were 52% higher in medial OA ( p ¼ 0.005) and 63% lower in lateral OA ( p < 0.001) compared to controls. Cases with medial OA had 98 more, whereas those with lateral OA had 68 less external tibial rotation than controls (medial vs. lateral OA, p ¼ 0.001). We found an association between presence of lateral OA of the knee and the biomechanics of the hip joint. It remains to be evaluated if the changed biomechanics of the hip joint is a reason for development of lateral OA or an observation that is a result of this disease. ß

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: Gait analysis of 30 patients and 15 controls

et al. 2006

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Patterns of compartment involvement in tibiofemoral osteoarthritis in men and women and in whites and African Americans

Wise

Niu

Yang

et al. 2012

Arthritis Care & Research

146

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Objective We conducted a cross-sectional study to describe the prevalence of tibiofemoral joint space narrowing (JSN) in medial and lateral compartments and assess whether it differs by gender and ethnic groups, and if it does, to what extent such a difference is accounted for by knee malalignment. Methods The NIH-funded Multicenter Osteoarthritis (MOST) Study is an observational study of persons age 50 to 79 years with either symptomatic knee OA or at high risk of disease. Knee radiographs were assessed for JSN in each tibiofemoral compartment. Mechanical axis angle was measured using full-limb films. We compared the proportion of knees with medial compartment JSN and with lateral JSN between men and women as well as Caucasians (CC) and African Americans (AA) using a logistic regression model adjusting for covariates (race or gender and BMI, age, education, clinic site), and used generalized estimating equations to account for correlation between two knees within a person. Results Of 5202 knees (2652 subjects), 1532 (29.5%) had medial JSN, and 427 (8.2%) had lateral JSN. Lateral JSN was more prevalent in women’s than in men’s knees (OR=1.9, 95% CI 1.5–2.4) and was also higher in knees of AA than in CC (OR=2.4, 95% CI: 1.7–3.3). Further adjustment for malalignment attenuated the OR for gender but not the OR for race. Conclusion Women and AA are more likely to have lateral JSN than men and Caucasians. Valgus malalignment may contribute to the higher prevalence in women.

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Abnormal loading of the hip and knee joints in unilateral hip osteoarthritis persists two years after total hip replacement

Stief

Schmidt

Drongelen³

et al. 2018

Journal Orthopaedic Research

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A total hip replacement (THR) is a common and routine procedure to reduce pain and restore normal activity. Gait analysis can provide insights into functional characteristics and dynamic joint loading situation not identifiable by clinical examination or static radiographic measures. The present prospective longitudinal study tested whether 2 years after surgery a THR would restore dynamic loading of the knee and hip joints in the frontal plane to normal. Instrumented gait analysis was performed shortly before surgery and approximately 2 years after THR on 15 unilateral hip osteoarthritis (OA) patients. 15 asymptomatic matched individuals were recruited as healthy controls. Results showed that abnormal joint loading persisted 2 years after THR. The 2nd external knee adduction moment in terminal stance in the affected (-34%, p = 0.002, d = 1.22) and non-affected limb (-25%, p = 0.035, d = 0.81) was lower compared to controls and thus indicated a shift in the knee joint load distribution from medial to lateral. A correlation analysis revealed that a smaller hip range of motion explained 46% of 2nd knee adduction moment alterations. In contrast, the 2nd external hip adduction moment in terminal stance was postoperatively higher in the affected (+22%, p = 0.007, d = 1.04) and non-affected limb (+22%, p = 0.005, d = 1.05). Here, 51% of 2nd hip adduction moment alterations can be explained with a greater hip adduction angle. Patients with a THR may therefore be at higher risk for abnormal joint loading and thus for the development of OA in other joints of the lower extremities. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

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Medial and lateral osteoarthritis of the knee is related to variations of hip and pelvic anatomy

Abstract: Our findings suggest that occurrence of medial or lateral OA has a biomechanical background originating from pelvis and hip anatomy.

Cited by 46 publications

References 16 publications

Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: Gait analysis of 30 patients and 15 controls

Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: Gait analysis of 30 patients and 15 controls

Patterns of compartment involvement in tibiofemoral osteoarthritis in men and women and in whites and African Americans

Abnormal loading of the hip and knee joints in unilateral hip osteoarthritis persists two years after total hip replacement

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