• 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, and International Spine Study Group (ISSG).
• Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
• Spine. 2024 Nov 6.

Study DesignRetrospective analysis of prospectively collected data.ObjectiveThis 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.BackgroundThe 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.MethodsBaseline 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.Results199 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.ConclusionIn 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.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

10 keywords...

hide…