Higher Association of Pelvis-Knee-Ankle Angle Compared With Hip-Knee-Ankle Angle With Knee Adduction Moment and Patient-Reported Outcomes After High Tibial Osteotomy

Autor: Koji Iwasaki, Yasumitsu Ohkoshi, Yoshiaki Hosokawa, Shuya Chida, Kengo Ukishiro, Kensaku Kawakami, Sho’ji Suzuki, Tatsunori Maeda, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki
Rok vydání: 2023
Předmět:
Zdroj: The American Journal of Sports Medicine. 51:977-984
ISSN: 1552-3365
0363-5465
Popis: Background: High tibial osteotomy (HTO) reduces the load distribution of the medial compartment by modifying leg alignment. Knee adduction moment (KAM), a surrogate measure of dynamic loading in the knee joint, decreases after HTO. However, leg alignment does not fully account for KAM. Purpose: To assess the association between the pelvis-knee-ankle angle (PKA), a novel radiographic parameter reflecting leg alignment and pelvic width, and KAM and patient-reported outcomes after HTO. Study Design: Cross sectional study; Level of evidence, 3. Methods: PKA is the angle between the line from the midpoint of the anterior superior iliac spine to the center of the knee joint and the mechanical axis of the tibia. In this study, 54 patients with medial compartment knee osteoarthritis and varus alignment who underwent 3-dimensional gait analysis preoperatively and 2 years after medial open-wedge HTO were evaluated. The primary outcomes were hip-knee-ankle angle (HKA), PKA, KAM peaks, and Knee Society Score (KSS). Single and multivariate regression analysis including PKA and KAM peaks as well as other demographic and radiologic factors was performed. Results: HKA was weakly correlated with the first peak KAM ( r = −0.33; P < .01) and second peak KAM ( r = −0.27; P = .01) before HTO, but not significantly correlated after HTO. PKA was moderately correlated with the first peak KAM ( r = 0.45; P < .01) and second peak KAM ( r = 0.45; P < .01) before HTO and with the first peak KAM ( r = 0.51; P < .01) and second peak KAM ( r = 0.56; P < .01) after HTO. Multivariate linear regression revealed that postoperative PKA was still associated with the KAM peaks after HTO. Only postoperative PKA was correlated with the KSS satisfaction subscale ( r = −0.30; P = .03). Conclusion: Although HKA was not correlated with KAM peaks after HTO, PKA was significantly correlated with KAM peaks in patients with varus knee osteoarthritis after HTO.
Databáze: OpenAIRE
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