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 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).
To evaluate and validate changes in SSPs following the correction of KFD by TKA.
The present study determined the sagittal spinopelvic parameters changes in patients with knee osteoarthritis, with or without knee flexion deformity, undergoing total knee arthroplasty.
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.
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.