Knee varus alters three-dimensional ankle alignment in standing- a study with upright computed tomography
Abstract Background For knee osteoarthritis (OA) treatment, it is important to correct the lower limb alignment including the foot. However, in the upright position, lower limb alignment is generally assessed from the body surface or radiographs, and it is a challenge to capture the exact characteri...
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-05235-7 |
| _version_ | 1819210115132162048 |
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| author | Satoshi Hakukawa Kazuya Kaneda Satoshi Oki Kengo Harato Yoshitake Yamada Yasuo Niki Takeo Nagura Masaya Nakamura Masahiro Jinzaki |
| author_facet | Satoshi Hakukawa Kazuya Kaneda Satoshi Oki Kengo Harato Yoshitake Yamada Yasuo Niki Takeo Nagura Masaya Nakamura Masahiro Jinzaki |
| author_sort | Satoshi Hakukawa |
| collection | DOAJ |
| description | Abstract Background For knee osteoarthritis (OA) treatment, it is important to correct the lower limb alignment including the foot. However, in the upright position, lower limb alignment is generally assessed from the body surface or radiographs, and it is a challenge to capture the exact characteristics of three-dimensional lower limb alignment. The purpose of the study was to measure lower limb alignment in patients with knee OA using upright computed tomography (CT) and radiography, and to identify features of knee joint deformity. Methods A total of 45 limbs in 25 patients with knee OA were enrolled. The subjects underwent both upright CT and radiography for the whole lower limb in the standing position. The joint angles were calculated on both images. The degree of knee OA was classified according to Kellgren-Lawrence (KL) grade by referring to radiography, which is mainly based on the degree of articular cartilage loss and severity of osteophytes, and the characteristics or correlation between knee and ankle joint in each group was investigated. Results In KL-I, there was an association between varus of the knee joint and internal rotation of the talocrural joint (r = 0.76, P < 0.05). In KL-II, there was an association between varus of the knee joint and eversion of the subtalar joint (r = 0.63, P < 0.05) and talocrural joint (r = − 0.65, P < 0.05). In KL-III, there was an association between varus of the knee joint and internal rotation of the subtalar joint (r = − 0.62, P < 0.05), and in KL-IV, there was an association between varus of the knee joint and internal rotation of the subtalar joint (r = − 0.58, P < 0.05). Conclusions The lower limb alignment of patients with knee OA in the standing position was found that as knee OA worsened, it became apparent that compensatory knee joint alignment depended on the ankle joint rather than the subtalar joint. The results may help in the rehabilitation of patients with knee OA, since the ankle joint alignment has a significant impact on the knee joint during coarse movements involving load. |
| first_indexed | 2024-12-23T06:06:02Z |
| format | Article |
| id | doaj.art-4c5100e52c59490da51a9e1c6c12996d |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-23T06:06:02Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-4c5100e52c59490da51a9e1c6c12996d2022-12-21T17:57:33ZengBMCBMC Musculoskeletal Disorders1471-24742022-04-0123111110.1186/s12891-022-05235-7Knee varus alters three-dimensional ankle alignment in standing- a study with upright computed tomographySatoshi Hakukawa0Kazuya Kaneda1Satoshi Oki2Kengo Harato3Yoshitake Yamada4Yasuo Niki5Takeo Nagura6Masaya Nakamura7Masahiro Jinzaki8Department of Orthopedic Surgery, Keio University Graduate School of medicineDepartment of Orthopedic Surgery, Keio University School of medicineDepartment of Orthopedic Surgery, Keio University School of medicineDepartment of Orthopedic Surgery, Keio University School of medicineDepartment of Radiology, Keio University School of medicineDepartment of Orthopedic Surgery, Keio University School of medicineDepartment of Orthopedic Surgery, Keio University School of medicineDepartment of Orthopedic Surgery, Keio University Graduate School of medicineDepartment of Radiology, Keio University School of medicineAbstract Background For knee osteoarthritis (OA) treatment, it is important to correct the lower limb alignment including the foot. However, in the upright position, lower limb alignment is generally assessed from the body surface or radiographs, and it is a challenge to capture the exact characteristics of three-dimensional lower limb alignment. The purpose of the study was to measure lower limb alignment in patients with knee OA using upright computed tomography (CT) and radiography, and to identify features of knee joint deformity. Methods A total of 45 limbs in 25 patients with knee OA were enrolled. The subjects underwent both upright CT and radiography for the whole lower limb in the standing position. The joint angles were calculated on both images. The degree of knee OA was classified according to Kellgren-Lawrence (KL) grade by referring to radiography, which is mainly based on the degree of articular cartilage loss and severity of osteophytes, and the characteristics or correlation between knee and ankle joint in each group was investigated. Results In KL-I, there was an association between varus of the knee joint and internal rotation of the talocrural joint (r = 0.76, P < 0.05). In KL-II, there was an association between varus of the knee joint and eversion of the subtalar joint (r = 0.63, P < 0.05) and talocrural joint (r = − 0.65, P < 0.05). In KL-III, there was an association between varus of the knee joint and internal rotation of the subtalar joint (r = − 0.62, P < 0.05), and in KL-IV, there was an association between varus of the knee joint and internal rotation of the subtalar joint (r = − 0.58, P < 0.05). Conclusions The lower limb alignment of patients with knee OA in the standing position was found that as knee OA worsened, it became apparent that compensatory knee joint alignment depended on the ankle joint rather than the subtalar joint. The results may help in the rehabilitation of patients with knee OA, since the ankle joint alignment has a significant impact on the knee joint during coarse movements involving load.https://doi.org/10.1186/s12891-022-05235-7HindfootWeightbearingWhole legs alignmentUpright computed tomography |
| spellingShingle | Satoshi Hakukawa Kazuya Kaneda Satoshi Oki Kengo Harato Yoshitake Yamada Yasuo Niki Takeo Nagura Masaya Nakamura Masahiro Jinzaki Knee varus alters three-dimensional ankle alignment in standing- a study with upright computed tomography BMC Musculoskeletal Disorders Hindfoot Weightbearing Whole legs alignment Upright computed tomography |
| title | Knee varus alters three-dimensional ankle alignment in standing- a study with upright computed tomography |
| title_full | Knee varus alters three-dimensional ankle alignment in standing- a study with upright computed tomography |
| title_fullStr | Knee varus alters three-dimensional ankle alignment in standing- a study with upright computed tomography |
| title_full_unstemmed | Knee varus alters three-dimensional ankle alignment in standing- a study with upright computed tomography |
| title_short | Knee varus alters three-dimensional ankle alignment in standing- a study with upright computed tomography |
| title_sort | knee varus alters three dimensional ankle alignment in standing a study with upright computed tomography |
| topic | Hindfoot Weightbearing Whole legs alignment Upright computed tomography |
| url | https://doi.org/10.1186/s12891-022-05235-7 |
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