Mohammad Daher, Alan H Daniels, Ashley Knebel, Mariah Balmaceno-Criss, Renaud Lafage, Lawrence G Lenke, Chrisotpher P Ames, Douglas Burton, Stephen M Lewis, Eric O Klineberg, Robert K Eastlack, Munish C Gupta, Gregory M Mundis, Jeffrey L Gum, Kojo D Hamilton, Richard Hostin, Peter G Passias, Themistocles S Protopsaltis, Khaled M Kebaish, Han Jo Kim, Frank Schwab, Christopher I Shaffrey, Justin S Smith, Breton Line, Shay Bess, Virginie Lafage, Bassel G Diebo
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It is also unknown how patients with knee arthroplasty and ASD compare to ASD patients with native knees.</p><p><strong>Methods: </strong>Baseline full-body radiographs were used, and hip and knee OA were graded by two independent reviewers using the KL classification. Spinopelvic parameters and PROMs were compared across the different knee OA groups and compared between patients with knee replacement and native knees.</p><p><strong>Results: </strong>199 patients with bilateral non severe OA (G1), 31 patients with unilateral severe knee OA (G2), and 60 patients with bilateral severe knee OA (G3). Patients with severe knee OA presented with worse spinopelvic parameters. However, after multivariable regression analysis controlling for age, frailty, PI, T1PA, knee OA was an independent predictor of knee flexion (G1:-0.02±7.3, G2: 7.8±9.4, G3: 4.5±8.7, P<0.001), and ankle dorsiflexion (G1: 2.3±4.0, G2: 6.6±4.5, G3: 5.1±4.1, P<0.001). There was no difference in PROMs (P>0.05). Secondary analysis included 96 patients: 48 patients (50%) with non-severe knee OA, and 48 patients (50%) with knee replacement. There was no difference in radiographic parameters or PROMs between the groups.</p><p><strong>Conclusion: </strong>In this study of complex ASD patients, patients with worse spinal deformity were more likely to have concomitant knee OA. Knee OA was shown to be a predictor of knee flexion and ankle dorsiflexion angles, but was not associated with worse PROMs in this study population. 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引用次数: 0
摘要
研究设计对前瞻性收集的数据进行回顾性分析：本研究评估了膝关节骨性关节炎（OA）和膝关节置换术对接受成人脊柱畸形（ASD）矫正手术患者的对线和患者报告结果测量（PROMS）的影响：背景：人们对ASD患者膝关节OA与脊柱排列之间的关系尚不完全清楚。背景：对ASD患者膝关节OA与脊柱排列之间的关系尚不完全清楚，也不知道膝关节置换术后的ASD患者与原生膝关节的ASD患者相比有何不同：方法：使用基线全身X光片，由两名独立审查员使用KL分类法对髋关节和膝关节OA进行分级。比较不同膝关节 OA 组的旋转盆骨参数和 PROMs，并对膝关节置换患者和原生膝关节患者进行比较：199例双侧非重度OA患者（G1）、31例单侧重度膝关节OA患者（G2）和60例双侧重度膝关节OA患者（G3）。严重膝关节OA患者的脊柱骨盆参数较差。然而，在控制了年龄、虚弱程度、PI、T1PA 的多变量回归分析后，膝关节 OA 是膝关节屈曲的独立预测因子（G1：-0.02±7.3，G2：7.8±9.4，G3：4.5±8.7，P0.05）。二次分析包括 96 名患者：非严重膝关节 OA 患者 48 例（50%），膝关节置换患者 48 例（50%）。两组患者的放射学参数和PROMs无差异：结论：在这项针对复杂ASD患者的研究中，脊柱畸形更严重的患者更有可能同时患有膝关节OA。研究显示，膝关节OA是膝关节屈曲和踝关节外翻角度的预测因子，但在本研究人群中，膝关节OA与更差的PROMs无关。然而，与轻度膝关节OA患者相比，膝关节置换术患者的脊柱排列和PROM具有可比性。
Impact of Knee Osteoarthritis and Arthroplasty on Full Body Sagittal Alignment in Adult Spinal Deformity Patients.
Study design: Retrospective analysis of prospectively collected data.
Objective: This study evaluates the impact of knee osteoarthritis (OA) and knee arthroplasty on alignments and patient-reported outcomes measures (PROMS) of patients undergoing adult spinal deformity (ASD) corrective surgery.
Background: The relationship between knee OA and spinal alignment in patients with ASD is incompletely understood. It is also unknown how patients with knee arthroplasty and ASD compare to ASD patients with native knees.
Methods: Baseline full-body radiographs were used, and hip and knee OA were graded by two independent reviewers using the KL classification. Spinopelvic parameters and PROMs were compared across the different knee OA groups and compared between patients with knee replacement and native knees.
Results: 199 patients with bilateral non severe OA (G1), 31 patients with unilateral severe knee OA (G2), and 60 patients with bilateral severe knee OA (G3). Patients with severe knee OA presented with worse spinopelvic parameters. However, after multivariable regression analysis controlling for age, frailty, PI, T1PA, knee OA was an independent predictor of knee flexion (G1:-0.02±7.3, G2: 7.8±9.4, G3: 4.5±8.7, P<0.001), and ankle dorsiflexion (G1: 2.3±4.0, G2: 6.6±4.5, G3: 5.1±4.1, P<0.001). There was no difference in PROMs (P>0.05). Secondary analysis included 96 patients: 48 patients (50%) with non-severe knee OA, and 48 patients (50%) with knee replacement. There was no difference in radiographic parameters or PROMs between the groups.
Conclusion: In this study of complex ASD patients, patients with worse spinal deformity were more likely to have concomitant knee OA. Knee OA was shown to be a predictor of knee flexion and ankle dorsiflexion angles, but was not associated with worse PROMs in this study population. Patients with knee arthroplasty, however, had comparable spinal alignment and PROMs relative to those with mild OA.
期刊介绍：
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Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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