Effect of spinopelvic alignment on KNEE osteoarthritis

Knee osteoarthritis (OA) is the most common joint disease in the world, the etiology of which has not been clearly elucidated. In this study, it was aimed to evaluate the effect of spinopelvic parameters on knee OA. 69 female patients with stage 2 and above knee osteoarthritis were included in the study. Stage 2 patients were considered early, stage 3 and 4 patients were considered severe stage OA. Demographic data of the cases were recorded, detailed clinical histories were taken, and physical examinations were performed. Visual Analogue Scale (VAS) was used to evaluate low back and knee pain in patients, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to evaluate knee joint function and disability, and Oswestry Low Back Pain Disability Questionnaire (ODI) was used to evaluate disability due to low back pain. Lateral scoliosis radiographs of all volunteers were taken. These images were taken from the PACS system and uploaded to the Surgimap v2.3.2.1 program, and measured pelvic incidence (PI), pelvic tilt (PT), sacral slope (SE), lumbar lordosis (LL), thoracic kyphosis (TK), and sagittal vertical axis (SVA) values were recorded. A total of 69 patients with a mean age of 61.62±5.13 years and a mean BMI of 31.84±6,05 kg/m2 were included in the study. 36 patients (52.2%) were classified as early stage and 33 patients (47.8%) were classified as severe stage OA. There was a weak positive correlation between patients' knee flexion angle (DFA) values and PI-LL (r=0.357; p=0.003) and TK (r=0.258; p=0.033). It was determined that the risk of high osteoarthritis severity increased with increasing BMI (OR: 1.239; p=0.007), SVA (OR: 1.055; p=0.008) and PI-LL (OR: 1.274; p=0.001). BMI (β=0.245, p=0.020), sagittal vertical axis (β=0.247, p=0.018) and PI-LL values (β=0.349, p=0.001) were positively correlated with the WOMAC Total score;Sacral slop values were found to be negatively correlated with the WOMAC total score (β=-0.219, p=0.026). Global sagittal imbalance and lumbopelvic dissonance increased the severity of knee OA, while pelvic retroversion was associated with disability in the knee. Pelvic retroversion was not associated with radiographic severity of knee OA, but was associated with poor functional outcomes in the knee. Evaluation of sagittal balance, which is a component of the kinetic chain in patients with knee OA, and the creation of personalized exercise programs to correct the imbalance that can be detected may prevent the progression of degeneration and contribute to the reduction of disability.