Relationship between Knee Osteoarthritis and Spinopelvic Sagittal Alignment in Volunteers over 50 Years of Age

Yasuda Tatsuya,Togawa Daisuke,Hasegawa Tomohiko,Yamato Yu,Kobayashi Sho,Yoshida Go,Banno Tomohiro,Arima Hideyuki,Oe Shin,Hoshino Hironobu,Koyama Hiroshi,Hanada Mitsuru,Imada Takayuki,Matsuyama Yukihir 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.4

Study Design: Large cohort study of volunteers.Purpose: The purpose of this study was to investigate the relationship between the severity of knee osteoarthritis, assessed using the Kellgren-Lawrence (KL) grading scale, and spinopelvic sagittal alignment in older adult volunteers.Overview of Literature: The relationship between spinopelvic alignment in the sagittal plane and knee osteoarthritis in the coronal plane is unclear.Methods: Volunteers over 50 years of age underwent radiographic analysis. Radiographic parameters including pelvic tilt (PT), pelvic incidence (PI), lumbar lordosis (LL), thoracic kyphosis, and sagittal vertical axis (SVA) were measured. The the three Scoliosis Research Society-Schwab sagittal modifiers (PT, SVA, I–LL) were categorized and the KL grade was assessed. Differences in spinopelvic parameters and Oswestry Disability Index (ODI) scores among KL grades were evaluated.Results: A total of 396 volunteers (160 men, 236 women; mean age, 74.4 years) were analyzed. PI–LL and PT in KL4 were significantly higher compared to that in the other KL grades. However, there were no significant group differences in SVA. In women, but not in men, higher frequencies of the worst modifier grade (++) were observed for PI–LL and PT in the KL3 and KL4 groups compared to those for the other KL grades. In women, the ODI score in KL4 was worse compared to that in the other KL grades.Conclusions: Individuals over 50 years of age with severe knee osteoarthritis had poor lumbo-pelvic sagittal alignment. Moreover, the progression severity of knee osteoarthritis had more impact onstronger relationship with lumbo-pelvic malalignment and disability-related low back pain in women than in men.

Relationship of Bone Mineral Density and Knee Osteoarthritis (Kellgren-Lawrence Grade): Fifth Korea National Health and Nutrition Examination Survey

Eun-Seok Choi,Hyun Dae Shin,Jae Ang Sim,Young Gon Na,Won-Jun Choi,Dae-Do Shin,백종민 대한정형외과학회 2021 Clinics in Orthopedic Surgery Vol.13 No.1

Background: Osteoarthritis (OA) and osteoporosis (OP) are the 2 most common bone disorders associated with aging. We can simply assume that older patients have a higher incidence of OA and OP with more severity. Although several papers have conducted studies on the relationship between OA and OP, none of them has demonstrated a conclusive link. In this study, we used radiological knee OA and bone mineral density (BMD; T-score of the total hip and lumbar spine) to analyze the incidence of OA and OP in a large population. We aimed to determine the relationship between OA and OP and investigate the associated risk factors. Methods: This cross-sectional study used data extracted from the 2010–2012 Korea National Health and Nutrition Examination Survey. We evaluated a total of 4,250 participants aged ≥ 50 years who underwent knee radiography and dual-energy X-ray absorptiometry and their laboratory results. The relationship between radiological knee OA and BMD was assessed. The generalized linear model was used to evaluate the relationship between BMD and Kellgren-Lawrence (KL) grade. Results: The higher KL grade was associated with older age, higher body mass index (BMI), female sex, and lower hemoglobin level (p < 0.001). No significant association was found between OA and the following variables: white blood cell, platelet, total cholesterol, vitamin D, alkaline phosphatase, parathyroid hormone, hypertension, diabetes, asthma, dyslipidemia, smoking status, alcohol consumption, and regular exercise (p > 0.05). After adjusting for confounding factors (age, BMI, diabetes, hypertension, smoking, and alcohol consumption), the average T-scores of total hip and lumbar spine were the highest in the mild OA group with KL grade 2 (–0.22 ± 1.08 and –0.89 ± 1.46, respectively, p < 0.001). The average T-scores of the total hip and lumbar spine significantly decreased as OA progressed from moderate (KL grade 3; –0.49 ± 1.05 and –1.33 ± 1.38, respectively, p < 0.001) to severe (KL grade 4; –0.73 ± 1.13 and –1.74 ± 1.75, respectively, p < 0.001). T-scores of the moderate-to-severe OA group were significantly lower than those of the non-OA group (KL grades 0 and 1, p < 0.001). Conclusions: Compared with the non-OA group, BMD (T-scores of the total hip and lumbar spine) was higher in the mild OA group and lower in the moderate-to-severe OA group.

라이프케어테인먼트 기반 50세 이상 한국성인의 무릎관절염 유병률과 관련요인

정대인(Dae-In Jung),박종항(Jong-Hang Park),고대식(Dae-Sik Ko) 한국엔터테인먼트산업학회 2018 한국엔터테인먼트산업학회논문지 Vol.12 No.7

본 연구의 목적은 무릎관절염을 K/L 2등급 이상과 3등급 이상으로 구분하여 유병률의 차이를 알아보고 관련요인을 규명하여 무릎관절염의 예방교육자료 및 보건사업의 기초자료를 제공하기 위해 실시하였다. 국민건강영양조사 제5기 3차년도 자료 중 50세 이상 성인 2,906명을 최종대상자로 선정하였다. 연구결과 한국 50세 이상 성인의 K/L 2등급 이상 무릎관절염의 유병률은 33.4%이었고, 이를 남성과 여성의 유병률로 구분하면 각각 20.1%, 43%이었다. K/L 3등급 이상은 19.9%이었고, 남성은 9.5%, 여성은 27.3%이었다. 무릎관절염은 K/L 2등급 이상에서 성, 연령, 교육정도, 흡연상태, 체질량지수, 무릎관절통 유무, 무릎관절 통증수준과 유의한 상관성이 있었고, K/L 3등급 이상은 성, 연령, 체질량지수, 무릎관절통 유무, 무릎관절 통증수준과 유의한 상관성이 있었다. This study was performed to provide the basic data for healthcare services and educational materials to prevent knee osteoarthritis by identifying different prevalence of Kellgren/Lawrence grade 2 and 3 and their related risk factors. Among the 5th survey in 3rd year Korean National Health and Nutrition Examination Survey data, 2,906 people over 50 years old were selected as final subjects. The result showed that the prevalence of knee osteoarthritis as K/L grade 2 was 33.4% in Koreans over 50 years old and the prevalence in male and female were 20.1% and 43% respectively. The prevalence of K/L grade 3 for knee osteoarthritis was 19.9% and the prevalence in male was 9.5% and in female was 27.3%. For knee osteoarthritis as K/L grade 2, gender, age, educational level, smoking status, body mass index, knee joint pain, and the level of knee pain were significantly correlated and for K/L grade 3, gender, age, body mass index, knee joint pain, and the level of knee pain showed significant correlations.

Analysis of changes in tibial torsion angle on open-wedge high tibial osteotomy depending on the osteotomy level

( In-soo Song ),( Junhan Kwon ) 대한슬관절학회 2022 대한슬관절학회지 Vol.34 No.-

Purpose: This study evaluated the tibial torsional angle changes of 72 knees before and after open-wedge high tibial osteotomy (OWHTO) and compared the results according to the osteotomy level. Materials and methods: Seventy patients (72 knees) with Kellgren-Lawrence grade 3 underwent OWHTO. Demographic data, operation procedures, and measurement of mechanical tibiofemoral angle (mTFA), anatomical tibiofemoral angle (aTFA), tibial torsional angle (TTA), and pre- and postoperative Lysholm and International Knee Documentation Committee (IKDC) scores were obtained. The authors analyzed TTA changes between 30 knees with high-level osteotomy (group A) and 42 knees with low-level osteotomy (group B). Results: The changes of TTAs in the subjects of 72 knees went from 29.26 ± 5.6° preoperative mean to 25.36 ± 6.4° postoperative mean (p = 0.032). The postoperative TTAs of group A (mean 27.4 ± 4.8°) and B (mean 25.7 ± 4.9°) were statistically significant (p < 0.01). Preoperative Lysholm and IKDC scores of 72 knees had means of 49.1 ± 3.5 and 49.0 ± 15.2, respectively, and postoperative means of 85.7 ± 8.56 and 78.0 ± 17.6, respectively, which were statistically significant (p < 0.01). Conclusions: Changes of TTA with internal rotation of distal tibia were observed following OWHTO. High-level osteotomy on the proximal tibia’s lateral cortex had less internal rotation of the distal tibia than low-level osteotomy.

Ultrasound Findings were Associated With Radiographic Changes, But Not Clinical and Functional Outcomes in Hand Osteoarthritis

( Seong-kyu Kim ),( Ui Hong Jung ),( Ji-won Kim ),( Jung-yoon Choe ) 대한류마티스학회 2021 대한류마티스학회지 Vol.28 No.1

Objective. There is a debate over the relevance of ultrasound abnormalities to the pain, functional impairment, and radiologic severity in hand osteoarthritis (OA). This study aims to determine the association between ultrasound abnormalities and clinical, functional, and radiographic measures in hand OA. Methods. A total of 66 patients was consecutively enrolled. All patients with gray-scale synovitis, joint effusion, and osteophytes were examined by ultrasound for 20 hand joints. Radiographic changes in both hands were evaluated by the Kellgren-Lawrence (K-L) grading system and were described as total radiographic severity score and number of affected joints. Other measures were also assessed, including each patient’s visual analogue scale for pain, the Functional Index for Hand Osteoarthritis for functional disability, and grip and pinch strength for hand muscle strength. Results. In total, 10 patients with gray-scale synovitis, 35 with joint effusion, and 66 with osteophytes were detected in hand OA scans on ultrasound. Osteophytes on ultrasound were significantly associated with total radiographic severity score and number of affected joint (r=0.293, p=0.003 and r=0.336, p<0.001, respectively). In addition, there were weak associations of synovitis and joint effusion with radiographic changes. Patients with higher total radiographic severity score showed larger number of ultrasound-detected abnormalities, such as synovitis, joint effusion, and osteophytes (p=0.011, p=0.002, and p<0.001, respectively). Conclusion. This study shows that ultrasound findings, especially osteophytes, were associated with radiographic changes based on K-L grade, but not clinical and functional status in hand OA. (J Rheum Dis 2021;28:17-24)

무릎 연골 두께 아틀라스를 통한 손상 평가 기법

이용우,안천수,신지태,Lee, Yong-Woo,Bui, Toan Duc,Ahn, Chunsoo,Shin, Jitae 대한의용생체공학회 2015 의공학회지 Vol.36 No.2

Osteoarthritis is the most common chronic joint disease in the world. With its progression, cartilage thickness tends to diminish, which causes severe pain to human being. One way to examine the stage of osteoarthritis is to measure the cartilage thickness. When it comes to inter-subject study, however, it is not easy task to compare cartilage thickness since every human being has different cartilage structure. In this paper, we propose a method to assess cartilage defect using MRI inter-subject thickness comparison. First, we used manual segmentation method to build accurate atlas images and each segmented image was labeled as articular surface and bone-cartilage interface in order to measure the thickness. Secondly, each point in the bone-cartilage interface was assigned the measured thickness so that the thickness does not change after registration. We used affine transformation and SyGN to get deformation fields which were then applied to thickness images to have cartilage thickness atlas. In this way, it is possible to investigate pixel-by-pixel thickness comparison. Lastly, the atlas images were made according to their osteoarthritis grade which indicates the degree of its progression. The result atlas images were compared using the analysis of variance in order to verify the validity of our method. The result shows that a significant difference is existed among them with p < 0.001.