Static knee alignment and its association with radiographic knee osteoarthritis

Teichtahl, Andrew; Cicuttini, Flavia Maria; Janakiramanan, Neela; Davis, Susan Ruth; Wluka, Anita E.

doi:10.1016/j.joca.2006.04.014

Cited by 44 publications

(32 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, it has been our anecdotal observation that patients undergoing revision ACL reconstruction have varus malalignment more frequently than patients undergoing primary ACL reconstruction. If this is the case, preexisting medial tibiofemoral joint problems in the patients with failed ACL reconstruction can lead to more adverse consequences; varus malalignment is known to be one of the most important factors for progression of preexisting medial tibiofemoral OA and aggravation of symptoms [5,6,[18][19][20]22]. Moreover, in patients with large, irreparable medial meniscal tears, combined varus malalignment can further aggravate mechanical stress on the medial tibiofemoral joint and may result in early degeneration of the joint [3,7,13].…”

Section: Introductionmentioning

confidence: 99%

Coronal Limb Alignment and Indications for High Tibial Osteotomy in Patients Undergoing Revision ACL Reconstruction

Won

Chang

et al. 2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Failed ACL reconstruction frequently is accompanied by irreparable medial meniscal tear and/or visible osteoarthritis (OA) in the medial tibiofemoral joint. Thus, assessment for the presence of varus malalignment is important in caring for patients in whom revision ACL reconstruction is considered. Questions/purposesWe determined whether patients undergoing revision ACL reconstruction (1) have more frequent varus malalignment coupled with more severe degrees of medial meniscal injury and/or medial tibiofemoral OA, and (2) would meet potential indications for high tibial osteotomy more frequently than patients undergoing primary ACL reconstruction. Methods We compared 58 patients undergoing revision ACL reconstruction and 116 patients undergoing primary ACL reconstruction. The mechanical tibiofemoral angle and the weight loading line (%) of the knee were measured. Additionally, radiographic degrees of OA in the tibiofemoral joints, and meniscal conditions were assessed. Then, proportions of potential candidates for high tibial osteotomy between the two groups were compared based on the following indications: (1) weight loading line less than 5%, (2) weight loading line less than 25% and medial tibiofemoral OA Kellgren-Lawrence Grade 3 or greater, or (3) weight loading line less than 25% and Kellgren-Lawrence Grade 2 medial tibiofemoral OA plus subtotal or total medial meniscectomy status. Results The revision ACL reconstruction group had more frequent varus malalignment in terms of proportion of knees with more varus mechanical tibiofemoral angle than varus 5°(19% versus 8%, p = 0.029) and knees with weight loading line less than 25% (22% versus 9%, p = 0.011). This group also had more frequent high-grade injury of the medial meniscus (34% versus 16%, p = 0.007) and tended to have more frequent higher-grade radiographic OA at the medial tibiofemoral joint (19% versus 9%, p = 0.076). The percentage of patients meeting potential indications for high tibial osteotomy was greater in this group (14% versus 2%, p = 0.003). Conclusions We found that many patients undergoing revision ACL surgery may be reasonable candidates for concurrent high tibial osteotomy to address concomitant alignment and OA issues in the medial compartment. However, whether that additional intervention is offset by added risk and morbidity should be the focus of a future study, as it cannot be answered by a study of this design.

show abstract

Section: Introductionmentioning

confidence: 99%

Coronal Limb Alignment and Indications for High Tibial Osteotomy in Patients Undergoing Revision ACL Reconstruction

Won

Chang

et al. 2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…However, each method resulted in larger individual differences relative to radiographs, reaching 5.1°, 5.5°, and 3.8° for the trochanter, Bell, and functional methods, respectively. Since the division of radiographic alignments is based on a small scale (180±2° for neutral) and incremental progressions in malalignment are strongly related to joint space narrowing, size of osteophytes, and subsequent osteoarthritis progression (Felson et al, 2005;Sharma, 2001;Teichtahl et al, 2006), it is important that non-radiographic assessments of alignment be accurate. Therefore, caution should be exercised using these motion capture prediction methods for mechanical axis estimations, as inconsistent clinical assessments are possible.…”

Section: Discussionmentioning

confidence: 99%

Validation of the greater trochanter method with radiographic measurements of frontal plane hip joint centers and knee mechanical axis angles and two other hip joint center methods

Bennett

Shen

Weinhandl

et al. 2016

Journal of Biomechanics

View full text Add to dashboard Cite

“…The presence of genu varum or genu valgus may lead to greater weightbearing loads and is associated with increased risk of joint space narrowing in the medial or lateral compartment, respectively. 92 In addition, limb length, femoral anteversion, hip rotation flexibility, pelvis position, and foot alignment should be carefully evaluated. Furthermore, alterations in gait can have a significant effect on the knee joint.…”

Section: Physical Examinationmentioning

confidence: 99%

Rehabilitation of Articular Lesions in the Athlete's Knee

Wilk

Briem²,

Reinold³

et al. 2006

J Orthop Sports Phys Ther

View full text Add to dashboard Cite

Articular cartilage lesions of the knee joint are common in patients of varying ages. Some articular cartilage lesions are focal lesions located on one aspect of the tibiofemoral or patellofemoral joint. Other lesions can be extremely large or involve multiple compartments of the knee joint and these are often referred to as osteoarthritis. There are numerous potential causes for the development of articular cartilage lesions: joint injury (trauma), biomechanics, genetics, activities, and biochemistry. Numerous factors also contribute to symptomatic episodes resulting from lesions to the articular cartilage: activities (sports and work), joint alignment, joint laxity, muscular weakness, genetics, dietary intake, and body mass index. Athletes appear to be more susceptible to developing articular cartilage lesions than other individuals. This is especially true with specific sports and subsequent to specific types of knee injuries. Injuries to the anterior cruciate ligament and/or menisci may increase the risk of developing an articular cartilage lesion. The treatment for an athletic patient with articular cartilage lesions is often difficult and met with limited success. In this article we will discuss several types of knee articular cartilage injuries such as focal lesions, advanced full-thickness lesions, and bone bruises. We will also discuss the risk factors for developing full-thickness articular cartilage lesions and osteoarthritis, and describe the clinical evaluation and nonoperative treatment strategies for these types of lesions in athletes.

show abstract

Static knee alignment and its association with radiographic knee osteoarthritis

Cited by 44 publications

References 12 publications

Coronal Limb Alignment and Indications for High Tibial Osteotomy in Patients Undergoing Revision ACL Reconstruction

Coronal Limb Alignment and Indications for High Tibial Osteotomy in Patients Undergoing Revision ACL Reconstruction

Validation of the greater trochanter method with radiographic measurements of frontal plane hip joint centers and knee mechanical axis angles and two other hip joint center methods

Rehabilitation of Articular Lesions in the Athlete's Knee

Contact Info

Product

Resources

About