Puthiyapura LK, Jain M, Tripathy SK, Puliappadamb HM. Effect of osteoarthritic knee flexion deformity correction by total knee arthroplasty on sagittal spinopelvic alignment in Indian population. World J Clin Cases 2022; 10(21): 7348-7355 [PMID: 36158011 DOI: 10.12998/wjcc.v10.i21.7348]
Corresponding Author of This Article
Mantu Jain, MD, Doctor, Surgeon, Department of Orthopaedics, AIIMS Bhubaneswar, Sijua, Bhubaneswar 751019, Odisha, India. montu_jn@yahoo.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Lubaib Karaniveed Puthiyapura, Mantu Jain, Sujit Kumar Tripathy, Department of Orthopaedics, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
Haridas Mundot Puliappadamb, Department of Pharmacology, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
Author contributions: Jain M conceived the idea with Tripathy SK and obtained ethical clearance for the study; Jain M, Tripathy SK and Puthiyapura LK were involved in sample collection; Puthiyapura LK followed up the cases and compiled the data; Puliappadamb HM did the statistics; Jain M and Puthiyapura LK wrote the manuscript with critical input provided by all authors; all authors have read and agree to content of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional ethics committee of AIIMS Bhubaneswar (IEC/AIIMS BBSR/PG Thesis/2019-20/94).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mantu Jain, MD, Doctor, Surgeon, Department of Orthopaedics, AIIMS Bhubaneswar, Sijua, Bhubaneswar 751019, Odisha, India. montu_jn@yahoo.com
Received: January 15, 2022 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
ARTICLE HIGHLIGHTS
Research background
Sagittal alignment of the spine, pelvis, and lower extremities is essential for stable and efficient posture and walking. An imbalance in any element results in compensatory changes in other elements. Knee flexion, a compensatory mechanism for sagittal alignment of the spine and pelvis, is significantly affected in severe knee osteoarthritis (OA). Correction of knee flexion deformity (KFD) by total knee arthroplasty (TKA) results in complementary changes in sagittal spine-pelvic parameters (SSPs).
Research motivation
To evaluate and validate changes in SSPs following the correction of KFD by TKA.
Research objectives
The present study determined the sagittal spinopelvic parameters changes in patients with knee osteoarthritis, with or without knee flexion deformity, undergoing total knee arthroplasty.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
The direction of further studies should include a larger sample size, longer follow-up time, and clinical lower back pain scores to strengthen the findings of this study.
