Lateral osteoarthritis of the knee: etiology based on morphological, anatomical, kinematic and kinetic observations.
This thesis aimed to study osteoarthritis (OA) of the knee and its subgroup with lateral wear (valgus knees). Anatomy, kinematics and kinetics (movements and moments) of the hip and knee joint and the sensitivity and specificity of diagnostic procedures were evaluated. Our hypothesis was that there...
| Publicado en: | Acta Orthopaedica (Supplement) Vol. 77; pp. 3 - 45 |
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| Autor principal: | |
| Formato: | diagnostic images pictorial review tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
Jun2006 Supplement 322
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106128091&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106128091 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453690 1WHY jtl: Acta Orthopaedica (Supplement) issn: 17453690 maglogo: N pubinfo: dt: Jun2006 Supplement 322 vid: 77 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 106128091 106128091 2009622064 NLM16886718 106128091 ppf: 3 ppct: 42 formats: fmt: @attributes: type: P tig: atl: Lateral osteoarthritis of the knee: etiology based on morphological, anatomical, kinematic and kinetic observations. aug: au: Weidow J affil: Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy at Göteborg University, Sahlgrenska University Hospital, Göteborg, Sweden sug: subj: Hip Joint Physiology Kinematics Kinetics Knee Joint Physiology Osteoarthritis, Knee Etiology Osteoarthritis, Knee Physiopathology Aged Aged, 80 and Over Biomechanics Cartilage, Articular Pathology Diagnosis, Musculoskeletal Methods Equipment Reliability Female Knee Radiography Male Middle Age Osteoarthritis, Knee Epidemiology Radiography Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: This thesis aimed to study osteoarthritis (OA) of the knee and its subgroup with lateral wear (valgus knees). Anatomy, kinematics and kinetics (movements and moments) of the hip and knee joint and the sensitivity and specificity of diagnostic procedures were evaluated. Our hypothesis was that there are biomechanical reasons for development of either lateral or medial OA.The wear pattern of the tibial plateau and the femoral condyles was delineated in 42 patients. The diagnostic accuracy of standing knee radiographs was validated in 34 and reproducibility and validity of the Ahlbaeck classification was studied in 48 patients. The Influence of working conditions or gender on the prevalence of uni or bilateral knee OA was evaluated in 990 patients from 2 hospitals (Varberg and Halmstad) operated during 1985-1994 with knee arthroplasty or proximal tibial osteotomy. For each patient, 3 age- and gender-matched controls were found. Studies of the anatomy of the hip and pelvic regions and the motions and moments in the hip and knee in medial and lateral OA were performed. The detailed kinematics of the knee during active extension in lateral OA were recorded using dynamic radiostereometry (RSA).In both medial and lateral OA the central part of the tibial plateau showed the most pronounced wear (p<0.001), followed by the anterior part in medial OA (p=0.02) and the posterior part in lateral OA (p=0.001).In medial OA the observed difference between the 2 radiographic methods was small and accept-able (median; p=0.05; 0--0.5 mm). In lateral OA there was no consistent underestimation, but larger scatter (median; p=0.04; -0.1-1.2 mm) suggesting less precise determination.The repeatability of the Ahlbaeck classification for one observer was fair (kappa: medial OA: 0.15-0.65; lateral OA: 0.59-0.76), but between observers it was poor (kappa: 0.1). The validity revealed an acceptable sensitivity in both medial (67-95%) and lateral (43--86%) OA but the specificity was low (medial: 11--67%; lateral: 25--75%).Farmers (RR: 1.7; p<0.0005) and building workers (RR: 1.4; p=0.047) run increased risk to undergo surgical treatment because of OA of the knee. Unilateral disease was 3.7 times more common among men.Patients with lateral knee OA had a 14 mm wider pelvis (p=0.001) and those with medial knee OA an 11 mm higher offset (p=0.005). In the gait analysis they showed more outward rotation of the hip (p=0.001) and more inward rotation of the tibia than did patients with medial OA (p=0.001).In lateral OA, the medial femoral condyle translated 7-8 mm forward with 45 degrees flexion whereas controls translated 4 mm less (p=0.03), without any difference of the lateral femoral condyle.Conventional radiographs do not give sufficient information for correct grading, especially in lateral OA where the scatter is high. The joint space can often be seen on radiographs despite presence of bone attrition as observed on the preparations. Increased incidence of unilateral disease in men and building workers suggests that this joint disease more commonly originates from previous trauma. Our findings suggest that the occurrence of medial or lateral OA has a biomechanical background originating from pelvis and hip anatomy. pubtype: Academic Journal doctype: diagnostic images pictorial review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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