Prevalence of proximal tibia vara in Indonesian population with knee osteoarthritis |
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| Institution: | 1. Department of Orthopaedic Surgery, Zuyderland Medical Center Heerlen and Sittard-Geleen, Dr. H. van der Hoffplein 1, 6162, BG Geleen, the Netherlands;2. School of Care and Public Health Research Institute, Faculty of Health, Medicine & Life Sciences, Maastricht University Medical Centre, P. Debyelaan 25, 6202, AZ Maastricht, the Netherlands;3. School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 60, 6229, ER Maastricht, the Netherlands;1. Orthopedic and Traumatology Department, Policlinico San Pietro, Via Carlo Forlanini 15, Ponte San Pietro, 24036, Italy;2. Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Italy;3. Department of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy;4. Department of Biology, Lakehead University, Thunder Bay, ON, Canada, P7B5E1;5. Hospital Couple Enfant, Grenoble, France;6. Orthopedic Department, San Gerardo Hospital, Via Pergolesi 33, Monza, 20900, Italy;1. Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, India;2. Department of Radiology, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, India |
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| Abstract: | BackgroundProximal tibia vara has drawn interest since the concept of constitutional varus was introduced. Proximal tibia vara is a condition where the knee varus tilt the tibia condyle medially and shift the tibial articular surface medially. This condition affects medial proximal tibial angle measurements and the placement of the tibial implant in knee replacement surgery. Thus, it challenged the neutral knee arthroplasty alignment target because some people may present a proximal tibia vara. This study assesses the prevalence of the proximal tibia vara and the correlation to knee osteoarthritis grade.MethodsThis retrospective study was carried out from January 2021 to June 2021. Eighty-five limbs were included with the following inclusion criteria: knee osteoarthritis patients who received a long view lower extremity radiograph. The exclusions criteria were (1) patients who had undergone arthroplasty and lower extremity surgery before and (2) valgus knee deformity. The outcomes in this study were HKAA, MAD, TAD, MPTA, PTRP, LDFA, and PTS. Intraclass correlation (ICC) using two-way mixed was used to assess the reproducibility of the radiographic parameters. Multiple logistic regression was used to evaluate the correlation between knee osteoarthritis grade and radiographs parameters (MAD and TAD).ResultA total 85 limbs from 52 patients were assessed in this study. Proximal tibia vara was found in 18 knees (21%.). The logistic regression was performed to assess the correlation between the severity of the knee osteoarthritis and radiographic parameters (MAD, TAD, LDFA, and PTS) with an overall p-value < 0.001 and pseudo-R2 = 0.29.ConclusionA significant portion of patients with knee osteoarthritis have proximal tibia vara, and it is a pre-existing condition. Since the pre-existing proximal tibia vara affects preoperative measurements, a long-standing lower extremity x-ray is recommended to be obtained as part of knee replacement preparation. |
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| Keywords: | Tibia vara Knee osteoarthritis Constitutional knee varus |
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