| Title: | Higher Association of Pelvis-Knee-Ankle Angle Compared With Hip-Knee-Ankle Angle With Knee Adduction Moment and Patient-Reported Outcomes After High Tibial Osteotomy |
| Authors: | Iwasaki, Koji Browse this author →KAKEN DB |
| Ohkoshi, Yasumitsu Browse this author |
| Hosokawa, Yoshiaki Browse this author |
| Chida, Shuya Browse this author |
| Ukishiro, Kengo Browse this author |
| Kawakami, Kensaku Browse this author |
| Suzuki, Sho'ji Browse this author |
| Maeda, Tatsunori Browse this author |
| Onodera, Tomohiro Browse this author →KAKEN DB |
| Kondo, Eiji Browse this author →KAKEN DB |
| Iwasaki, Norimasa Browse this author →KAKEN DB |
| Keywords: | high tibial osteotomy |
| knee |
| osteoarthritis |
| knee adduction moment |
| gait analysis |
| Issue Date: | 1-Mar-2023 |
| Publisher: | SAGE Publications |
| Journal Title: | American journal of sports medicine |
| Volume: | 51 |
| Issue: | 4 |
| Start Page: | 977 |
| End Page: | 984 |
| Publisher DOI: | 10.1177/03635465221150513 |
| Abstract: | Background: High tibial osteotomy (HTO) reduces the load distribution of the medial compartment by modifying leg alignment. Knee adduction moment (KAM), a surrogate measure of dynamic loading in the knee joint, decreases after HTO. However, leg alignment does not fully account for KAM. Purpose: To assess the association between the pelvis-knee-ankle angle (PKA), a novel radiographic parameter reflecting leg alignment and pelvic width, and KAM and patient-reported outcomes after HTO. Study Design: Cross sectional study; Level of evidence, 3. Methods: PKA is the angle between the line from the midpoint of the anterior superior iliac spine to the center of the knee joint and the mechanical axis of the tibia. In this study, 54 patients with medial compartment knee osteoarthritis and varus alignment who underwent 3-dimensional gait analysis preoperatively and 2 years after medial open-wedge HTO were evaluated. The primary outcomes were hip-knee-ankle angle (HKA), PKA, KAM peaks, and Knee Society Score (KSS). Single and multivariate regression analysis including PKA and KAM peaks as well as other demographic and radiologic factors was performed. Results: HKA was weakly correlated with the first peak KAM (r = -0.33; P < .01) and second peak KAM (r = -0.27; P = .01) before HTO, but not significantly correlated after HTO. PKA was moderately correlated with the first peak KAM (r = 0.45; P < .01) and second peak KAM (r = 0.45; P < .01) before HTO and with the first peak KAM (r = 0.51; P < .01) and second peak KAM (r = 0.56; P < .01) after HTO. Multivariate linear regression revealed that postoperative PKA was still associated with the KAM peaks after HTO. Only postoperative PKA was correlated with the KSS satisfaction subscale (r = -0.30; P = .03). Conclusion: Although HKA was not correlated with KAM peaks after HTO, PKA was significantly correlated with KAM peaks in patients with varus knee osteoarthritis after HTO. |
| Rights: | wasaki K, Ohkoshi Y, Hosokawa Y, et al. Higher Association of Pelvis-Knee-Ankle Angle Compared With Hip-Knee-Ankle Angle With Knee Adduction Moment and Patient-Reported Outcomes After High Tibial Osteotomy. The American Journal of Sports Medicine. 2023;51(4): pp.977-984. Copyright © 2023. DOI: 10.1177/03635465221150513. |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/91336 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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