Tibiofemoral Osteoarthritis and Varus–Valgus Laxity

Abstract

The purpose of this study was to systematically review and synthesize the literature measuring varus-valgus laxity in individuals with tibiofemoral osteoarthritis (OA). Specifically, we aimed to identify varus-valgus laxity differences between persons with OA and controls, by radiographic disease severity, by frontal plane knee alignment, and by sex. We also aimed to identify if there was a relationship between varus-valgus laxity and clinical performance and self-reported function. We systematically searched for peer-reviewed original research articles in PubMed, Scopus, and CINAHL to identify all existing literature regarding knee OA and objective measurement of varus-valgus laxity in vivo. Forty articles were identified that met the inclusion criteria and data were extracted. Varus-valgus laxity was significantly greater in individuals with OA compared with controls in a majority of studies, while no study found laxity to be significantly greater in controls. Varus-valgus laxity of the knee was reported in persons with OA and varying degrees of frontal plane alignment, disease severity, clinical performance, and self-reported function but no consensus finding could be identified. Females with knee OA appear to have more varus-valgus laxity than males. Meta-analysis was not possible due to the heterogeneity of the subject populations and differences in laxity measurement devices, applied loading, and laxity definitions. Increased varus-valgus laxity is a characteristic of knee joints with OA. Large variances exist in reported varus-valgus laxity and may be due to differences in measurement devices. Prospective studies on joint laxity are needed to identify if increased varus-valgus laxity is a causative factor in OA incidence and progression.

Association of malalignment, muscular dysfunction, proprioception, laxity and abnormal joint loading with tibiofemoral knee osteoarthritis - a systematic review and meta-analysis

“…Impaired proprioception refers to deterioration of the ability to detect knee joint position and movement [ 4 ]. Laxity is a loss of passive joint stabilisation due to the inability of passive structures in and around the knee (knee ligaments, cruciate ligaments, capsule) to provide an adequate counterbalance to the mechanical forces acting upon the knee during activity [ 7 ]. Abnormal loading during gait is often represented by evaluating external knee joint moments or the occurrence of varus or valgus thrust [ 9 ].…”

Relationship between surgical balancing and outcome measures in total knees

“…Comparing these values with those of normal knees is not easy because the available data on normal intact knees and on total knee patients show variable results. This has been attributed to the differences in patient groups including age, sex, and follow-up time and to the measurement parameters including the equipment used, the moment applied, and the flexion angle [20] . One study comparable to ours measured the angles in extension and flexion on older patients with an average age of 62 years, measuring angles radiographically, which is expected to be accurate [17] .…”

Comportamento Da Atividade Muscular Durante Agachamento Unipodal Na Osteoartrite De Joelho

“…Na F2, o aumento da atividade do GM pode ter sido em resposta a tentativa de induzir maior flexão plantar para gerar impulso de verticalização corpo, e evitar o deslocamento anterior da tíbia, facilitando o movimento. 7 Além disso, pode ter ocorrido a rotação medial do quadril durante a subida, que é capaz de aumentar o comprimento tensão do músculo GM e atividade muscular para estabilização da pelve, justificando a maior ativação do músculo GLM associada a rotação medial do fêmur em relação a tíbia para promover o destrave durante a extensão do joelho 8 . Outra explicação seria adoção do provável padrão de co-ativação muscular associado à menor amplitude de movimento visando estabilizar o membro, 1 devido a complexidade da tarefa de agachamento somado ao medo da dor e a tentativa de manter o controle postural.…”