Introduction/objective: Knee alignment and anterior cruciate ligament (ACL) injury are risk factors for knee osteoarthritis (OA). The objective was to examine interactions between knee alignment and ACL status on cartilage volume loss in participants with or at risk of knee OA.
Method: Participants were from the Osteoarthritis Initiative, a longitudinal cohort study. Data were from baseline and 24- and 72-month follow-up visits. Participants with knee OA (progression subcohort) or at risk of knee OA (incidence subcohort) that had partial or full ACL tears (OA-ACL group; n=66) or an intact ACL (OA-only group, n=367) were selected. Femur-tibia angles from radiographs quantified knee alignment. Changes in tibial and femoral cartilage volumes were measured using magnetic resonance imaging. Hierarchical linear models examined if knee alignment, presence of ACL, and their interaction were related to cartilage volume loss after accounting for other variables.
Results: Interactions between alignment and ACL status were significantly related to cartilage volume loss in the lateral plateau (β=-20.19, 95% confidence interval [CI]=-34.65 to -5.73) and lateral condyle (β=-23.64, 95%CI=-43.06 to -4.23). Valgus alignment was related to lateral compartment cartilage loss in the OA-ACL group, but not in the OA-only group. Varus alignment was related to cartilage loss in the medial plateau (β=7.49, 95%CI=0.17 to 14.80) and medial condyle (β=19.70, 95%CI=5.96 to 33.44) in both groups.
Conclusion: The impact of knee alignment on knee OA initiation and progression varies based on ACL status. Initial lateral compartment damage or changes in joint kinematics after ACL rupture might account for these findings.Key Points• The relationship between knee alignment and lateral compartment cartilage loss depended on the status of the anterior cruciate ligament in participants with knee osteoarthritis or at risk for knee osteoarthritis.• Valgus alignment was related to lateral compartment cartilage loss in participants with a deficient anterior cruciate ligament.• Varus alignment was related to medial compartment cartilage loss regardless of the status of the anterior cruciate ligament.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1007/s10067-019-04759-z | DOI Listing |
J Am Acad Orthop Surg Glob Res Rev
January 2025
From the Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo, Tokyo (Dr. Kono, Dr. Taketomi, Dr. Kage, Dr. Inui, and Dr. Tanaka); the Department of Information Systems, Faculty of Engineering, Saitama Institute of Technology, Fukaya, Saitama (Dr. Yamazaki); the Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Suita, Osaka (Dr. Tamaki, and Dr. Tomita); the Department of Orthopedic Surgery, Saitama Medical University, Saitama Medical Center, Kawagoe, Saitama (Dr. Inui); and the Department of Health Science, Graduate School of Health Science, Morinomiya University of Medical Sciences, Suminoe, Osaka, Japan (Dr. Tomita).
Background: The effect of axial rotation between the femoral neck and ankle joint (total rotation [TR]) on normal knees is unknown. Therefore, this study aimed to investigate the TR effect on normal knee kinematics.
Methods: Volunteers were divided into groups large (L), intermediate (I), and small (S), using hierarchical cluster analysis based on TR in the standing position.
J Exp Orthop
January 2025
Department of Orthopaedic Surgery and Trauma University Center of Montpellier, University of Montpellier Montpellier France.
Purpose: Gap-balanced total knee arthroplasty (TKA) technique relies on initial ligament evaluation, particularly in patient-specific implantation using computer-assisted technologies. This cadaveric study aimed to compare the reproducibility and reliability of medial and lateral gap measurements between manual stress testing and dynamic ligament balancer.
Methods: Initial gap acquisitions were assessed from eight cadaveric knees (four specimens) during the same navigated TKA procedure by five differently skilled surgeons (three seniors and two juniors).
BMC Musculoskelet Disord
January 2025
VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, 450 Broadway Street MC: 6342, Redwood City, CA, 94603, USA.
Background: As value-based care arrangements continue to assess quality of care and costs, comprehensive and patient-centered definitions of quality of care are required. While patient-reported outcome measures are increasingly integrated into quality assessments following total joint arthroplasty (TJA), patient perceptions of quality paired with the phase of surgical care has not been described. The purpose of this study was to assess how TJA patients perceive measures of quality of care and assess if these perceptions change based on the phase of care.
View Article and Find Full Text PDFSICOT J
January 2025
Department of Orthopaedic Surgery, Joint Replacement Unit, Kuala Lumpur Hospital, Ministry of Health Malaysia, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
Introduction: Extraarticular deformity (EAD) with knee arthritis is a complex condition involving tri-planar bone deformity with pathological malalignment and chronic soft tissue contracture or laxity in the knee joint. Intraarticular correction by TKA, which was previously performed with conventional manual jig by mechanical alignment technique, had its limits and difficulties especially extensive soft tissue release and risk of jeopardizing the collateral ligaments. Robotic technology allows for reproducible and precise execution of surgical plan and allows adjustment to various new personalised alignment philosophy including functional alignment (FA).
View Article and Find Full Text PDFJ Orthop
July 2025
MBBS, FRACS, FAOthA, Consultant Orthopaedic Surgeon, Melbourne Orthopaedic Group, Melbourne, Victoria, Australia.
Background: A contemporary trend favours a restricted kinematic alignment (rKA) strategy, incorporating safe boundaries to restore a variable percentage of a patient's natural alignment.This study aims to compare preoperative and postoperative coronal plane knee alignment (CPAK) in patients undergoing bilateral TKA with SAIPH implants (MatOrtho, UK). The concept was to control the implant (same prosthesis both sides), patient (bilateral model) and assess what effect any surgical alteration in alignment had on patient's outcomes measured by patient-reported outcome measures (PROMS) and patient satisfaction.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!