Relationship between knee osteoarthritis and lower extremity joint alignment

Method: Patients diagnosed with primary medial tibiofemoral knee osteoarthritis were included in our study. Demographic data of the patients were taken. Anteroposterior 2-way knee radiographs were taken and evaluated according to the Kellgren-Lawrence system. Directly on the graph; medial joint space, lateral joint space, condylar angle, anatomical axis angle, tibial plateu angle and condylar plateu angle measurements were evaluated digitally. Using a goniometer for hip measurements; pelvic tilt angle, knee extension angle, femorotibial angle and Q angle were evaluated. To evaluate foot posture, the Foot Posture Index was used. The patients were evaluated with the Western Ontario and Mc Master University Osteoarthritis Index (WOMAC) questionnaire to evaluate their pain and functional status. Results: 150 patients (76 women, 74 men) with an average of 54±10 years were included in the study. In term of foot posture groups; supination, neutral and pronation percentages, %14.0, %48.3 ve %37.7 respectively. Western Ontario and Mc Master University Osteoarthritis Index total score was found to be higher in the supination group (P= 0.001), the medial joint space was found to be at lower values (p=0.000), and the tibial plateu and condylar plateu angle were found to be at higher values (p values respectively; p=0.010 and p=0.000). When hip examination findings were correlated with WOMAC values in the study; it was found that the pelvic tilt angle was negatively associated with WOMAC pain, physical function score and total score, while the femorotibial angle was positively associated with WOMAC pain score and total score. When evaluated according to the KL staging system; itwas shown that as the KL stage progresses, the pelvic tilt and femorotibial angle values decrease and the Q angle and knee extension angle values increase. When the measurements made on anteroposterior knee radiographs are correlated with hip examination measurements; a positive, moderately significant relationship was found between MEA and pelvic tilt and Q angle. Conclusions: Foot and hip posture of patients with medial tibiofemoral knee osteoarthritis was found to be associated with clinical and radiological variables. When evaluating patiens with knee osteoarthritis, foot and hip posture should be taken into consideration.