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Noh JH, Song KI, Heo YS. Outcomes of cruciate-retaining total knee arthroplasty for osteoarthritis with severe varus deformity. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2022:10.1007/s00590-022-03463-0. [PMID: 36536108 DOI: 10.1007/s00590-022-03463-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Varus deformity is common in osteoarthritic knee. The purpose of this study was to investigate the clinical and radiographic outcomes after cruciate-retaining (CR) total knee arthroplasty (TKA) for severely varus osteoarthritic knees and compare them to those of mildly to moderately deformed osteoarthritic knees. METHODS Eight hundred ninety-four subjects were undergone CR TKA, 137 had severe varus deformity (group 1), and 757 had mild-to-moderate deformity (group 2) of the lower limb preoperatively. Pre- and postoperative outcomes were compared between two groups clinically and radiographically. RESULTS Mean follow-up period was 54.7 ± 28.9 months. Mean age was 77.8 ± 6.7 years in group 1 and 74.5 ± 7.4 years in group 2 (p < 0.001). Preoperative hip-knee-ankle angle (HKAA) was - 17.7°±2.9° in group 1 and - 6.3° ± 5.1° in group 2 (p < 0.001). Preoperative range of motion (ROM) was 127.7° ± 15.2° in group 1 and 130.8 °± 9.6° in group 2 (p = 0.019). Preoperative Knee Society scores and WOMAC score were not significantly different between two groups. Postoperative HKAA was - 0.4° ± 2.3° in group 1 and 0.6 ° ± 2.0° in group 2 (p < 0.001). Postoperative ROM, Knee Society scores, and WOMAC score were not significantly different between two groups. CONCLUSIONS CR TKA showed results in subjects with severe varus deformities comparable to those without severe varus deformities. Whether the degree of preoperative varus deformity of the lower limb should be considered when deciding to perform CR-type or PS-type TKA requires further discussion. LEVEL OF EVIDENCE Retrospective comparative study, Level III.
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Affiliation(s)
- Jung Ho Noh
- Department of Orthopaedic Surgery, Kangwon National University School of Medicine, 1 Gangwondaehak-Gil, Chuncheon-Si, Gangwon-Do, 24341, South Korea.
| | - Ki Ill Song
- Department of Orthopaedic Surgery, Kangwon National University Hospital, 156 Baengnyeong-Ro, Chuncheon-Si, Gangwon-Do, 24289, South Korea
| | - Yeon Sik Heo
- Department of Orthopaedic Surgery, Kangwon National University Hospital, 156 Baengnyeong-Ro, Chuncheon-Si, Gangwon-Do, 24289, South Korea
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Macri EM, Felson DT, Ziegler ML, Cooke TDV, Guermazi A, Roemer FW, Neogi T, Torner J, Lewis CE, Nevitt MC, Stefanik JJ. The association of frontal plane alignment to MRI-defined worsening of patellofemoral osteoarthritis: the MOST study. Osteoarthritis Cartilage 2019; 27:459-467. [PMID: 30500383 PMCID: PMC6391198 DOI: 10.1016/j.joca.2018.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/15/2018] [Accepted: 11/08/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the sex-specific relation of frontal plane alignment (FPA) to magnetic resonance imaging (MRI)-defined features of patellofemoral osteoarthritis, and also to tibiofemoral osteoarthritis and knee pain. METHOD The Multicenter Osteoarthritis Study is cohort study comprised of individuals with or at risk of knee osteoarthritis. We determined the sex-specific dose-response relation of baseline FPA to MRI-defined patellofemoral and tibiofemoral structural worsening, and incident knee pain, over 7 years. RESULTS In women only, greater varus alignment was associated with medial patellofemoral osteophytes (risk ratio [RR] 1.7 [95% CI 1.2, 2.6]) and valgus with lateral patellofemoral osteophytes (RR 1.9 [1.0, 3.6]). In men, greater varus increased risk for medial tibiofemoral cartilage worsening (RR 1.7 [1.1, 2.6]), and valgus for lateral tibiofemoral cartilage worsening (RR 1.8 [1.6, 2.2]). In women, findings were similar for tibiofemoral cartilage, but varus also increased risk for medial bone marrow lesions [BMLs] (RR 2.2 [1.6, 3.1]) and medial osteophytes (RR 1.8 [1.3, 2.5]), and valgus for lateral BMLs (RR 3.3 [2.2, 4.5]) and osteophytes (RR 2.0 [1.2, 3.2]). Varus increased risk of incident pain in men (RR 1.7 [1.4, 2.2]) and women (RR 1.3 [1.0, 1.6]), valgus did so in men only (RR 1.5 [1.1, 1.9]). CONCLUSION FPA was associated with patellofemoral osteophyte worsening in women, though overall was more strongly associated with tibiofemoral than patellofemoral osteoarthritis feature worsening. FPA in women was more consistently associated with structural worsening, yet men had higher associations with incident pain.
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Affiliation(s)
- E M Macri
- Department of Physical Therapy, University of Delaware, Newark, DE, USA; Department of General Practice, Erasmus MC, Rotterdam, NL.
| | - D T Felson
- Clinical Epidemiology Research and Training Unit, School of Medicine, Boston University, Boston, MA, USA; Division of Musculoskeletal & Dermatological Sciences, University of Manchester, Manchester, UK.
| | - M L Ziegler
- Biostatistics Core, College of Health Sciences, University of Delaware, Newark, DE, USA.
| | - T D V Cooke
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada.
| | - A Guermazi
- Quantitative Imaging Center, Department of Radiology, School of Medicine, Boston University, Boston, MA, USA.
| | - F W Roemer
- Quantitative Imaging Center, Department of Radiology, School of Medicine, Boston University, Boston, MA, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - T Neogi
- Clinical Epidemiology Research and Training Unit, School of Medicine, Boston University, Boston, MA, USA.
| | - J Torner
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA.
| | - C E Lewis
- Division of Preventive Medicine, University of Alabama, Birmingham, AL, USA.
| | - M C Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
| | - J J Stefanik
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, USA; Department of Physical Therapy, University of Delaware, Newark, USA.
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Macri EM, Stefanik JJ, Khan KK, Crossley KM. Is Tibiofemoral or Patellofemoral Alignment or Trochlear Morphology Associated With Patellofemoral Osteoarthritis? A Systematic Review. Arthritis Care Res (Hoboken) 2016; 68:1453-70. [DOI: 10.1002/acr.22842] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 11/23/2015] [Accepted: 01/12/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Erin M. Macri
- University of British Columbia; Vancouver British Columbia Canada
| | | | - Karim K. Khan
- University of British Columbia; Vancouver British Columbia Canada
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