A comparative study of weight-bearing and non-weight-bearing 3-dimensional lower extremity alignment in knee osteoarthritis |
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| Institution: | 1. Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, Niigata City, Niigata, 951-8510 Japan;2. Department of Orthopaedic Surgery, Niigata Medical Center, Niigata City, Niigata, 950-2022 Japan;3. Department of Orthopaedic Surgery, Nagaoka Central Hospital, Nagaoka City, Niigata, 954-8653 Japan;4. Department of Health and Sports, Niigata University of Health and Welfare, Niigata City, Niigata, 950-3198 Japan;5. Division of Orthopaedic Biomechanics, Hokuetsu Hospital, Shibata City, Niigata, 957-0018 Japan;1. Department of Orthopedic Surgery, The No.904 Hospital of Peoples Liberation Army, Wuxi 214000, China;2. Wuxi Clinical College of Anhui Medical University, Wuxi, 214000, China;1. Niigata Spine Surgery Center, Niigata, Japan;2. Dept. of Orthopaedic Surgery, Niigata University Hospital, Japan;1. Keio University School of Medicine, Department of Orthopaedic Surgery, Tokyo, Japan;2. Kobe Medical Center, Department of Orthopaedic Surgery, Kobe, Japan;3. Kanazawa University, Department of Orthopaedic Surgery, Kanazawa, Japan;4. Meijo Hospital, Department of Orthopaedic Surgery, Nagoya, Japan;5. Tokyo Shinjuku Medical Center, Department of Spine Surgery, Tokyo, Japan;6. Toyota Kosei Hospital, Department of Orthopaedic Surgery, Toyota, Japan;7. Japan Spinal Deformity Institute, Nagoya, Japan;1. Ningbo University School of Medicine, Ningbo, China;2. Department of Orthopaedics, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China;1. Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan;2. Department of Anesthesia, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan |
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| Abstract: | BackgroundLower extremity alignment is an important variable with respect to the development and progression of knee osteoarthritis. It is very essential for the preoperative planning of realignment surgeries such as total knee arthroplasty and high tibial osteotomy. Nevertheless, there have been no reports comparing 3D lower extremity alignment between weight-bearing upright and non-weight-bearing horizontal states in osteoarthritic knees in the same subject. Therefore, we determined whether the alignment of the lower extremity in the weight-bearing upright state differed from that in the non-weight-bearing horizontal or supine position in patients with knee osteoarthritis.MethodsAdduction–abduction, flexion–extension, and rotational angle of osteoarthritic knees were assessed in weight-bearing upright and non-weight-bearing supine positions. Knee alignment in the supine position was determined from preoperative computed tomography data. In the weight-bearing upright state, alignment was determined using a technique that utilized 2D-3D image-matching with biplanar computed radiography and 3D bone models of the complete lower extremity rebuilt using computed tomography-based information.ResultsWe assessed 81 limbs from osteoarthritic knee patients (74 women, 7 men; mean age 75.3 years, range 59–86 years). In the coronal plane, there were varus deformities in both the supine and standing positions, while there was flexion in both the supine upright state and position at the sagittal plane. In the axial plane, the rotation of the tibia to the femur was neutral in the supine position and internal in the upright state.ConclusionPatient position significantly affects lower extremity alignment in osteoarthritic knees. This study provides important data regarding the preoperative evaluation of realignment surgery in total knee arthroplasty and high tibial osteotomy. We believe that these results are an important contribution to the knowledge regarding knee osteoarthritis. |
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