下肢関節症と腰椎骨盤矢状面アライメントの関連について

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  • Influence of the Hip and Knee Osteoarthritis on Sagittal Lumbo-Pelvic Alignment
  • カシ カンセツショウ ト ヨウツイ コツバンヤジョウメン アライメント ノ カンレン ニ ツイテ

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<p>Objective: The purpose of this study was to investigate the association between sagittal lumbopelvic alignment (LPA) and osteoarthritis (OA) in lower limb joints, especially affecting the knee and the hip.</p><p>Methods: A total of 50 patients (7 men and 43 women) with a mean age of 72±9.6 years (range: 41-86 years) who were planned to undergo total knee or hip arthroplasty for OA were included. The patients were divided into three groups as follows: knee OA group (n＝24), hip OA group (n＝15), and knee and hip OA group (n＝11). Knee and hip OA was defined as grade 2 or above by radiographic findings based on the Kellgren-Lawrence classification. Preoperative lateral view radiographs of the lumbar spine and pelvis in the standing position were evaluated by measuring the following parameters: pelvic incidence (PI), lumbar lordosis (LL), the value of PI minus LL (PI-LL), sacral slope (SS), and pelvic tilt (PT). The Kruskal-Wallis test was used to evaluate the difference among the three groups, and Mann-Whitney U-test with Bonferroni correction was used for post-hoc pairwise comparison.</p><p>Results: PI in the three groups were not significantly different. LL in knee OA group (36.3±11.7°) and knee and hip OA group (34.6±8.6°) were significantly smaller than hip OA group (43.3±10.4°) (P<0.01). SS in knee OA group (28.2±7.3°) and knee and hip OA group (31.5±8.5°) were significantly smaller than hip OA group (36.5±6.8°) (P<0.01). PT in the knee OA group (22.2±6.8°) and both knee and hip OA group (19.5±9.8°) were significantly larger than the hip OA group (12.7±9.2°) (P<0.01). PI-LL values in the knee OA group (14.8±11.4°) and knee and hip OA group (16.3±9.4°) were significantly larger than hip OA group (5.9±10.5°) (P<0.01).</p><p>Conclusion: In the present study, smaller lumber lordosis and imbalance in PI-LL values were associated with knee OA, regardless of the presence of hip OA.</p>

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