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The effect of tibial rotation on knee medial and lateral compartment contact pressure

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The progression of knee osteoarthritis (OA) is determined in part by mechanical effects on local structures. The mechanical influences of limb malalignment on cartilage loss are well known; however, the effect of rotational deformities on knee OA is not yet known. The aim of the current study was to evaluate the effect of tibial rotation on knee medial and lateral compartment contact pressure.

Methods

The left knees of six fresh whole-body cadavers were used in this study. Fujifilm Prescale super-low type film was used for contact pressure measurement. The films were inserted into the joint after arthrotomy. The cadavers were stabilized with a custom-made device, and axial force of half body weight specific to each cadaver was applied to the plantar surface of the feet. The examination was repeated after osteotomy of the fibula and tibia, and the tibia was then rotated 15° or 30° internally (IR) or externally (ER) and securely fixed. The resulting films were scanned, and CP was determined using appropriate software.

Results

The p values for increased medial compartment contact pressure at 15° and 30° IR and 30° ER were 0.016, 0.025, and 0.025, respectively. For decreased medial compartment contact pressure at 15° ER, the p value was 0.020. The p values for increased lateral compartment contact pressure at 15° and 30° ER were 0.010 and 0.030, respectively. In this compartment, contact pressure changes at 15° and 30° IR were not significant.

Conclusion

This experimental study demonstrated that 15° IR of the tibial shaft increased contact pressure and 15° ER decreased contact pressure over the knee medial compartment.

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References

  1. Akalın Y, Ozçelik A, Köse N, Seber S (2011) Rotational alignment of the lower extremity in adults: no relationship with osteoarthritis of the knee was proved. Joint Dis Relat Surg 22(2):75–80

    Google Scholar 

  2. Andrews M, Noyes FR, Hewett TE, Andriacchi TP (1996) Lower limb alignment and foot angle are related to stance phase knee adduction in normal subjects: a critical analysis of the reliability of gait analysis data. J Orthop Res 14(2):289–295

    Article  PubMed  CAS  Google Scholar 

  3. Andriacchi TP, Lang PL, Alexander EJ, Hurwitz DE (2000) Methods for evaluating the progression of osteoarthritis. J Rehabil Res Dev 37:163–170

    PubMed  CAS  Google Scholar 

  4. Belo JN, Berger MY, Reijman M, Koes BW, Bierma-Zeinstra SM (2007) Prognostic factors of progression of osteoarthritis of the knee: a systematic review of observational studies. Arthritis Rheum 57(1):13–26

    Article  PubMed  CAS  Google Scholar 

  5. Bretin P, O’Loughlin PF, Suero EM et al (2010) Influence of femoral malrotation on knee joint alignment and intra-articular contract pressures. Arch Orthop Trauma Surg 131(8):1115–1120

    Article  PubMed  Google Scholar 

  6. Brouwer GM, Tol AW, Bergink AP et al (2007) Association between valgus and varus alignment and the development and progression of radiographic osteoarthritis of the knee. Arthritis Rheum 56:1204–1211

    Article  PubMed  CAS  Google Scholar 

  7. Cerejo R, Dunlop DD, Cahue S et al (2002) The influence of alignment on risk of knee osteoarthritis progression according to baseline stage of disease. Arthritis Rheum 46:2632–2636

    Article  PubMed  Google Scholar 

  8. Eckhoff DG, Johnston RJ, Stamm ER et al (1994) Effect of limb malrotation on malalignment and osteoarthritis. Orthop Clin North Am 25:405–414

    PubMed  CAS  Google Scholar 

  9. Farrokhi S, Voycheck CA, Klatt BA et al (2014) Altered tibiofemoral joint contact mechanics and kinematics in patients with knee osteoarthritis and episodic complaints of joint instability. Clin Biomechanics 29:629–635

    Article  Google Scholar 

  10. Felson DT (2004) An update on the pathogenesis and epidemiology of osteoarthritis. Radiol Clin North Am 42(1):1–9

    Article  PubMed  Google Scholar 

  11. Foroughi N, Smith R, Vanwanseele B (2009) The association of external knee adduction moment with biomechanical variables in osteoarthritis: a systematic review. Knee 16(5):303–309

    Article  PubMed  Google Scholar 

  12. Hudson D, Royer T, Richards J (2007) Bone mineral density of the proximal tibia relates to axial torsion in the lower limb. Gait Posture 26(3):446–451

    Article  PubMed  Google Scholar 

  13. Hunt MA, Birmingham TB, Griffin JR, Jenkyn TR (2006) Associations among knee adduction moment, frontal plane ground reaction force, and lever arm during walking in patients with knee osteoarthritis. J Biomech 39:2213–2220

    Article  PubMed  Google Scholar 

  14. Hunter DJ, Zhang Y, Niu J (2005) Structural factors associated with malalignment in knee osteoarthritis knee study. J Rheumatol 32:2197–2199

    Google Scholar 

  15. Hunter DJ, Niu J, Felson DT, Harvey WF, Gross KD et al (2007) Knee alignment does not predict incident osteoarthritis: the Framingham osteoarthritis study. Arthritis Rheum 56(4):1212–1218

    Article  PubMed  Google Scholar 

  16. Kenawey M, Liodakis E, Krettek C, Ostermeier S, Horn T, Hankemeier S (2011) Effect of the lower limb rotational alignment on tibiofemoral contact pressure. Knee Surg Sports Traumatol Arthrosc 19:1851–1859

    Article  PubMed  Google Scholar 

  17. Lohmander LS, Felson D (2004) Can we identify a ‘high risk’ patient profile to determine who will experience rapid progression of osteoarthritis? Osteoarthritis Cartilage 12(Suppl A):S49–S52

    Article  PubMed  Google Scholar 

  18. Mandeville DS, Krackow KA et al (2013) The effect of torsion deformity and medial knee osteoarthritis on lower limb extensor moments during gait. Open J of Rheum and Autoimmune Dis 3:119–124

    Article  Google Scholar 

  19. Miyazaki T, Wada M, Kawahara H et al (2002) Dynamic load at baseline can predict radiographic disease progression in medial compartment knee osteoarthritis. Ann Rheum Dis 61(7):617–622

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  20. Naruse K, Urabe K, Jiang SX et al (2009) Osteoarthritic changes of the patellofemoral joint in STR/OrtCrlj mice are the earliest detectable changes and may be caused by internal tibial torsion. Connect Tissue Res 50(4):243–255

    Article  PubMed  Google Scholar 

  21. Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD (2009) The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA 286:188–195

    Article  Google Scholar 

  22. Tanamas S, Hanna FS, Cicuttini FM et al (2009) Does knee malalignment increase the risk of development and progression of knee osteoarthritis? A systematic review. Arthritis Rheum 61(4):459–467

    Article  PubMed  Google Scholar 

  23. Turner MS (1994) The association between tibial torsion and knee joint pathology. Clin Orthop Relat Res 302:47–51

    PubMed  Google Scholar 

  24. Turner MS, Smillie IS (1981) The effect of tibial torsion on the pathology of the knee. J Bone Joint Surg 63:396–398

    Google Scholar 

  25. Yagi T (1994) Tibial torsion in patients with medial-type osteoarthritic knees. Clin Orthop Relat Res 302:52–56

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Knee Surgery, Firoozgar Hospital, School of Medicine, Iran University of Medical Science, Tehran, Iran

    Hamidreza Yazdi

  2. Biomechanics Department, School of Mechanical Engineering, Iran University of Science and Technology, Tehran, Iran

    Mohammadreza Mallakzadeh & Sara Sadat Farshidfar

  3. Shafa Rehabilitation Hospital, School of Medicine, Iran University of Medical Science, Tehran, Iran

    Behrooz Givehchian

  4. Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran

    Hamidreza Daneshparvar

  5. Department of Orthopedic Surgery, Medical University Innsbruck, Innsbruck, Austria

    Hannes Behensky

Authors
  1. Hamidreza Yazdi
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  2. Mohammadreza Mallakzadeh
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  3. Sara Sadat Farshidfar
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  4. Behrooz Givehchian
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  5. Hamidreza Daneshparvar
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  6. Hannes Behensky
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Correspondence to Hamidreza Yazdi.

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Yazdi, H., Mallakzadeh, M., Sadat Farshidfar, S. et al. The effect of tibial rotation on knee medial and lateral compartment contact pressure. Knee Surg Sports Traumatol Arthrosc 24, 79–83 (2016). https://doi.org/10.1007/s00167-014-3321-x

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  • DOI: https://doi.org/10.1007/s00167-014-3321-x

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