Lorenz Pichler, Rauf Alizada, Lea M S Cordes, Kerem Basarir, Asim Kayaalp, Reha Tandogan
{"title":"在接受全膝关节置换术的患者中，脊柱骨盆活动度降低与膝关节屈曲畸形无关。","authors":"Lorenz Pichler, Rauf Alizada, Lea M S Cordes, Kerem Basarir, Asim Kayaalp, Reha Tandogan","doi":"10.1002/ksa.70047","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the impact of reduced spinopelvic mobility (SM) on knee flexion deformity (KFD) in patients undergoing total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>A retrospective analysis on 213 patients (271 knees) undergoing robotic-assisted primary TKA was conducted. Sagittal spinopelvic alignment (SSA) parameters-sacral slope (SS), pelvic incidence (PI), and pelvic tilt (PT)-were measured on lateral standing and sitting spinopelvic radiographs. Patients were stratified according to established SM classifications: standing-sitting difference in SS ≥ 10° versus < 10°, PT ≥ 20° versus < 20°, and Dorr's classification (DC). KFD was assessed intraoperatively using a robotic-assisted surgical platform after placement of arrays: first in the native state (KFDb), and again after osteophyte removal and maximum manual correction (KFDa). Correlations between standing-sitting changes in SSAs and KFDb/KFDa, as well as differences in mean KFDb/KFDa between SM groups, were analysed.</p><p><strong>Results: </strong>The mean differences between standing and sitting was 11.3° (SD 9.1) for SS and 6.9° (SD 9.8) for PT. Based on SM classifications, 129 knees (48%) showed a SS difference < 10°, 30 knees (11%) a PT difference ≥ 20°, and DC categorised 131 (48%) as normal, 64 (24%) as stuck standing, 74 (27%) as stuck sitting, and 1% as kyphotic. The mean KFDb and KFDa were 5° (SD 6) and 2° (SD 2), respectively. No significant correlations were found between standing-sitting changes in SSAs and KFDb or KFDa (correlation coefficients < 0.1 for all). No significant differences in mean KFDb or KFDa were observed across SM classification groups (p > 0.2 for all).</p><p><strong>Conclusion: </strong>Spinopelvic mobility does not correlate with intraoperative knee flexion deformity in patients undergoing TKA suggesting that the increased knee flexion found among these patients is a dynamic rather than a permanent compensatory mechanism.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Reduced spinopelvic mobility does not correlate with knee flexion deformity in patients undergoing total knee arthroplasty.\",\"authors\":\"Lorenz Pichler, Rauf Alizada, Lea M S Cordes, Kerem Basarir, Asim Kayaalp, Reha Tandogan\",\"doi\":\"10.1002/ksa.70047\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The aim of this study was to evaluate the impact of reduced spinopelvic mobility (SM) on knee flexion deformity (KFD) in patients undergoing total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>A retrospective analysis on 213 patients (271 knees) undergoing robotic-assisted primary TKA was conducted. Sagittal spinopelvic alignment (SSA) parameters-sacral slope (SS), pelvic incidence (PI), and pelvic tilt (PT)-were measured on lateral standing and sitting spinopelvic radiographs. Patients were stratified according to established SM classifications: standing-sitting difference in SS ≥ 10° versus < 10°, PT ≥ 20° versus < 20°, and Dorr's classification (DC). KFD was assessed intraoperatively using a robotic-assisted surgical platform after placement of arrays: first in the native state (KFDb), and again after osteophyte removal and maximum manual correction (KFDa). Correlations between standing-sitting changes in SSAs and KFDb/KFDa, as well as differences in mean KFDb/KFDa between SM groups, were analysed.</p><p><strong>Results: </strong>The mean differences between standing and sitting was 11.3° (SD 9.1) for SS and 6.9° (SD 9.8) for PT. Based on SM classifications, 129 knees (48%) showed a SS difference < 10°, 30 knees (11%) a PT difference ≥ 20°, and DC categorised 131 (48%) as normal, 64 (24%) as stuck standing, 74 (27%) as stuck sitting, and 1% as kyphotic. The mean KFDb and KFDa were 5° (SD 6) and 2° (SD 2), respectively. No significant correlations were found between standing-sitting changes in SSAs and KFDb or KFDa (correlation coefficients < 0.1 for all). No significant differences in mean KFDb or KFDa were observed across SM classification groups (p > 0.2 for all).</p><p><strong>Conclusion: </strong>Spinopelvic mobility does not correlate with intraoperative knee flexion deformity in patients undergoing TKA suggesting that the increased knee flexion found among these patients is a dynamic rather than a permanent compensatory mechanism.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":520702,\"journal\":{\"name\":\"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.70047\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/ksa.70047","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Reduced spinopelvic mobility does not correlate with knee flexion deformity in patients undergoing total knee arthroplasty.
Purpose: The aim of this study was to evaluate the impact of reduced spinopelvic mobility (SM) on knee flexion deformity (KFD) in patients undergoing total knee arthroplasty (TKA).
Methods: A retrospective analysis on 213 patients (271 knees) undergoing robotic-assisted primary TKA was conducted. Sagittal spinopelvic alignment (SSA) parameters-sacral slope (SS), pelvic incidence (PI), and pelvic tilt (PT)-were measured on lateral standing and sitting spinopelvic radiographs. Patients were stratified according to established SM classifications: standing-sitting difference in SS ≥ 10° versus < 10°, PT ≥ 20° versus < 20°, and Dorr's classification (DC). KFD was assessed intraoperatively using a robotic-assisted surgical platform after placement of arrays: first in the native state (KFDb), and again after osteophyte removal and maximum manual correction (KFDa). Correlations between standing-sitting changes in SSAs and KFDb/KFDa, as well as differences in mean KFDb/KFDa between SM groups, were analysed.
Results: The mean differences between standing and sitting was 11.3° (SD 9.1) for SS and 6.9° (SD 9.8) for PT. Based on SM classifications, 129 knees (48%) showed a SS difference < 10°, 30 knees (11%) a PT difference ≥ 20°, and DC categorised 131 (48%) as normal, 64 (24%) as stuck standing, 74 (27%) as stuck sitting, and 1% as kyphotic. The mean KFDb and KFDa were 5° (SD 6) and 2° (SD 2), respectively. No significant correlations were found between standing-sitting changes in SSAs and KFDb or KFDa (correlation coefficients < 0.1 for all). No significant differences in mean KFDb or KFDa were observed across SM classification groups (p > 0.2 for all).
Conclusion: Spinopelvic mobility does not correlate with intraoperative knee flexion deformity in patients undergoing TKA suggesting that the increased knee flexion found among these patients is a dynamic rather than a permanent compensatory mechanism.
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