TY - JOUR
T1 - Impact of Knee Osteoarthritis and Arthroplasty on Full-body Sagittal Alignment in Adult Spinal Deformity Patients
AU - and on behalf of the International Spine Study Group (ISSG)
AU - Daher, Mohammad
AU - Daniels, Alan H.
AU - Knebel, Ashley
AU - Balmaceno-Criss, Mariah
AU - Lafage, Renaud
AU - Lenke, Lawrence G.
AU - Ames, Chrisotpher P.
AU - Burton, Douglas
AU - Lewis, Stephen M.
AU - Klineberg, Eric O.
AU - Eastlack, Robert K.
AU - Gupta, Munish C.
AU - Mundis, Gregory M.
AU - Gum, Jeffrey L.
AU - Hamilton, Kojo D.
AU - Hostin, Richard
AU - Passias, Peter G.
AU - Protopsaltis, Themistocles S.
AU - Kebaish, Khaled M.
AU - Kim, Han Jo
AU - Schwab, Frank
AU - Shaffrey, Christopher I.
AU - Smith, Justin S.
AU - Line, Breton
AU - Bess, Shay
AU - Lafage, Virginie
AU - Diebo, Bassel G.
N1 - Publisher Copyright:
© 2024 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2025/4/15
Y1 - 2025/4/15
N2 - 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. One hundred ninety-nine patients with bilateral nonsevere 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 nonsevere knee OA, and 48 patients (50%) with knee replacement. There was no difference in radiographic parameters or PROMs between the groups. Conclusions. In this study of complex ASD patients, patients with worse spinal deformities 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.
AB - 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. One hundred ninety-nine patients with bilateral nonsevere 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 nonsevere knee OA, and 48 patients (50%) with knee replacement. There was no difference in radiographic parameters or PROMs between the groups. Conclusions. In this study of complex ASD patients, patients with worse spinal deformities 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.
KW - adult spinal deformity
KW - knee osteoarthritis
KW - patient-reported outcome measures
KW - spinal alignment
UR - http://www.scopus.com/inward/record.url?scp=85209946636&partnerID=8YFLogxK
U2 - 10.1097/BRS.0000000000005206
DO - 10.1097/BRS.0000000000005206
M3 - Article
C2 - 39505566
AN - SCOPUS:85209946636
SN - 0362-2436
VL - 50
SP - 508
EP - 514
JO - Spine
JF - Spine
IS - 8
ER -