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The coronal inclination of the medial tibial plateau affects coronal gait kinematics for varus osteoarthritic knees

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aims to (1) measure the kinematics of lower extremity alignment and the bony position relative to the ground during walking, focusing on the coronal plane, and (2) determine the correlation between the kinematics and coronal inclination of the medial tibial plateau (coronal inclination) for healthy and varus knee osteoarthritis (OA).

Methods

In this study, 43 women (non-OA, 9 knees; early OA, 13 knees; advanced OA, 21 knees; mean age 58 ± 17 years) were examined. The knee phenotypes in varus knee OA were varied. Three-dimensional (3D) knee kinematics were calculated in gait analysis by combining the motion capture system and the 3D lower extremity alignment assessment system via biplanar long-leg X-rays, applying the 3D–2D registration technique. The main parameters were the kinematics of the bony axes relative to the ground in the coronal plane during the stance phase of the gait. The differences in overall kinematics were assessed using repeated measures ANOVA with Tukey’s post hoc test. The association between kinematic parameters and coronal inclination was evaluated by multiple linear regression after univariate analysis.

Results

The tibia tilted laterally during the loading response, and a plateau area subsequently appeared until the terminal stance phase, whereas the femur slowly tilted laterally until the terminal stance phase. The dynamic alignment showed a relatively large varus angular change during the loading response in all groups. The trend of motion was similar among all groups (p = n.s.), although to varying degrees. The coronal inclination was the more dominant factor than the Kellgren–Lawrence (K–L) grades (β =  − 0.423, p = 0.005) when the change in dynamic alignment was determined.

Conclusions

The TAA plateau area after the loading response implies that the tibial articular surface may become horizontal. The femur slowly tilted laterally until the terminal stance phase in response to the tibial motion. Consequently, the dynamic alignment showed a varus angular change, in which coronal MCT was more involved than K–L grades.

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Funding

This study received KAKENHI from grants–in–aid for scientific research in Japan society for the promotion of science.

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Authors and Affiliations

  1. Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata, 951-8510, Japan

    Tomoharu Mochizuki, Osamu Tanifuji, Hiroshi Koga & Hiroyuki Kawashima

  2. Department of Health and Sports, Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan

    Go Omori

  3. Niigata Institute for Health and Sports Medicine, Niigata, Japan

    Katsutoshi Nishino & Masaei Tanaka

  4. National Institute of Technology, Tsuruoka College, Yamagata, Japan

    Tomoharu Mochizuki & Takahiro Mori

  5. Department of Orthopaedic Surgery, Nioji Onsen Hospital, Niigata, Japan

    Yoshio Koga

Authors
  1. Tomoharu Mochizuki
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  2. Osamu Tanifuji
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  3. Go Omori
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  4. Katsutoshi Nishino
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  5. Masaei Tanaka
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  6. Hiroshi Koga
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  7. Takahiro Mori
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  8. Yoshio Koga
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  9. Hiroyuki Kawashima
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Corresponding author

Correspondence to Tomoharu Mochizuki.

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The authors received and will not receive any benefits or funding from any commercial party related directly or indirectly to the subject of this article.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Mochizuki, T., Tanifuji, O., Omori, G. et al. The coronal inclination of the medial tibial plateau affects coronal gait kinematics for varus osteoarthritic knees. Knee Surg Sports Traumatol Arthrosc 30, 4162–4172 (2022). https://doi.org/10.1007/s00167-022-07019-x

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  • DOI: https://doi.org/10.1007/s00167-022-07019-x

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