Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7348
Peer-review started: January 15, 2022
First decision: April 8, 2022
Revised: April 15, 2022
Accepted: May 27, 2022
Article in press: May 27, 2022
Published online: July 26, 2022
Processing time: 176 Days and 13.5 Hours
Sagittal alignment of the spine, pelvis, and lower extremities is essential for maintaining a stable and efficient posture and ambulation. Imbalance in any element can result in compensatory changes in the other elements. Knee flexion is a compensatory mechanism for spinopelvic sagittal alignment and is markedly affected in severe knee osteoarthritis (OA). The correction of knee flexion deformity (KFD) by total knee arthroplasty (TKA) can lead to complementary changes in the sagittal spinopelvic parameters (SSPs).
To determine the SSP changes in patients with knee OA, with or without KFD undergoing TKA.
The study was conducted in 32 patients who underwent TKA. A neutral standing whole-spine lateral radiograph was performed before surgery and 3 mo after surgery in these patients. Subjects were divided into two groups (Group 1 obtained > 10° corrections in KFD; group B obtained < 10° correction). The pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), and sagittal vertical axis (SVA) were measured.
The median of change in PT, PI, SS, LL, and SVA was 0.20 mm, 1.00 mm, 2.20 mm, −0.40 mm, and 6.8 mm, respectively. The difference in the change in SSPs between the two groups was statistically non-significant.
SSPs, such as PI, PT, SS, LL, and SVA, do not change significantly following TKA in end-stage knee OA despite a significant correction (> 10°) in KFD.
Core Tip: The sagittal alignment of the spine, pelvis, and lower extremities is essential for maintaining a stable and efficient posture and ambulation. Any imbalance in one element can result in compensatory changes in the other. Low back pain arising from hip pathology was termed “hip spine syndrome.” As the sagittal spinopelvic parameters (SSPs) were described, the researchers became inquisitive about documenting these changes in hip pathology and post-surgical correction. After two decades, the “knee spine syndrome” was described in a similar logical sequence. The SSPs have become an area of interest with several user-friendly tools to measure. The current papers evaluate these parameters in patients with osteoarthritis knee and undergoing total knee replacement.