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Pardo F, La Mattina AA, Diquattro E, Lucchini S, Viceconti M, Minerba A, Castagnini F, Traina F. Chronological Changes in Sagittal Femoral Bowing after Primary Cementless Total Hip Arthroplasty: A Comparative 3D CT Study. J Pers Med 2023; 13:1704. [PMID: 38138931 PMCID: PMC10744357 DOI: 10.3390/jpm13121704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/15/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Little is known about dynamic changes of femoral anatomy after total hip arthroplasty (THA), in particular about sagittal femoral bowing (SFB). A 3D CT study was designed to evaluate the chronological changes of SFB after cementless femoral stem implantation for primary THA. Ten patients who underwent unilateral primary THA with a cementless femoral stem, with 2 consecutive CT scans (extending from the fourth lumbar vertebra to the tibial plateaus), performed before THA and at least 3 years after THA, were enrolled. The 3D models of femurs were created using image segmentation software. Using the two CT scans, SFB values of the proximal and middle thirds were calculated on the replaced and untreated sides by two different observers. Eight anatomical stems and two conical stems were involved. The post-operative CT was performed at an average follow-up of 6.5 years after THA (range: 3-12.5). The measurements performed by the two observers did not differ in the proximal and middle regions. A significant difference between the pre-operative and post-operative SFB compared to the untreated side was found in the proximal femur segment (p = 0.004). Use of a cementless stem in THA induced chronological changes in SFB of the proximal femur, after a minimum timespan of 3 years.
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Affiliation(s)
- Francesco Pardo
- Orthopedics-Traumatology and Prosthetic Surgery and Hip and Knee Revision, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Antonino Amedeo La Mattina
- Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Industrial Engineering, Alma Mater Studiorum—University of Bologna (IT), 40136 Bologna, Italy
| | - Emanuele Diquattro
- Orthopedics-Traumatology and Prosthetic Surgery and Hip and Knee Revision, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Stefano Lucchini
- Orthopedics-Traumatology and Prosthetic Surgery and Hip and Knee Revision, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Marco Viceconti
- Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Industrial Engineering, Alma Mater Studiorum—University of Bologna (IT), 40136 Bologna, Italy
| | - Andrea Minerba
- Orthopedics-Traumatology and Prosthetic Surgery and Hip and Knee Revision, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Francesco Castagnini
- Orthopedics-Traumatology and Prosthetic Surgery and Hip and Knee Revision, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Francesco Traina
- Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, 40127 Bologna, Italy;
- Head of Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d’Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy
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Hwang D, Wook Choi M, Kim SH, Han HS, Bum Chang C, Chul Lee M, Lee NK, Hyun Ro D. Age and sex differences in coronal lower extremity alignment in a healthy Asian population. Knee 2023; 45:198-206. [PMID: 37931367 DOI: 10.1016/j.knee.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 06/26/2023] [Accepted: 09/20/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND The purpose of this study was to analyze the coronal alignment of lower extremities according to age and sex in a healthy population and demonstrate the differences. METHODS Standing full-lower limb anteroposterior (AP) radiographs of healthy volunteers (670 males and 782 females) aged 18-69 years were retrospectively analyzed. The hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), joint line convergence angle and femoral bowing angle (FBA) were measured. The radiographic parameters were compared according to groups of age and sex. The proportion of volunteers with varus or valgus alignment more than 3° were also analyzed. RESULTS With increasing age, HKA and LDFA varus increased. With increasing age, femoral medial bowing decreased. In addition, the HKA showed more varus alignment in males than in females (178.01° vs. 178.82°, P < 0.001). The MPTA was about 1° smaller in males than in females (P < 0.001). The proportion of patients with varus alignment of more than 3° increased with increasing age, with 16.9% in the 10-19 years old and 38.0% in the 60-69 years old groups. CONCLUSION This study demonstrated that males showed more varus tibial alignments than females. Varus limb alignment, LDFA, and FBA also increases with age. In contrast, tibial alignment was constant across all age groups. Therefore, differences in lower extremity alignment according to age and sex should be considered in estimating individual prearthritic alignments.
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Affiliation(s)
- Doohyun Hwang
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Wook Choi
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seong-Hwan Kim
- Department of Orthopedic Surgery, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Hyuk-Soo Han
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea; Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chong Bum Chang
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Myung Chul Lee
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea; Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Na-Kyoung Lee
- Department of Orthopaedic Surgery, National Medical Center, Seoul, Republic of Korea.
| | - Du Hyun Ro
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea; Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; CONNECTEVE Co. LTD, Seoul, Republic of Korea.
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Scorcelletti M, Zange J, Böcker J, Sies W, Lau P, Mittag U, Reeves ND, Ireland A, Rittweger J. Associations between long-term exercise participation and lower limb joint and whole-bone geometry in young and older adults. Front Physiol 2023; 14:1150562. [PMID: 37250122 PMCID: PMC10211427 DOI: 10.3389/fphys.2023.1150562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction: Features of lower limb bone geometry are associated with movement kinematics and clinical outcomes including fractures and osteoarthritis. Therefore, it is important to identify their determinants. Lower limb geometry changes dramatically during development, partly due to adaptation to the forces experienced during physical activity. However, the effects of adulthood physical activity on lower limb geometry, and subsequent associations with muscle function are relatively unexplored. Methods: 43 adult males were recruited; 10 young (20-35 years) trained i.e., regional to world-class athletes, 12 young sedentary, 10 older (60-75 years) trained and 11 older sedentary. Skeletal hip and lower limb geometry including acetabular coverage and version angle, total and regional femoral torsion, femoral and tibial lateral and frontal bowing, and frontal plane lower limb alignment were assessed using magnetic resonance imaging. Muscle function was assessed recording peak power and force of jumping and hopping using mechanography. Associations between age, training status and geometry were assessed using multiple linear regression, whilst associations between geometry and muscle function were assessed by linear mixed effects models with adjustment for age and training. Results: Trained individuals had 2° (95% CI:0.6°-3.8°; p = 0.009) higher femoral frontal bowing and older individuals had 2.2° (95% CI:0.8°-3.7°; p = 0.005) greater lateral bowing. An age-by-training interaction indicated 4° (95% CI:1.4°-7.1°; p = 0.005) greater acetabular version angle in younger trained individuals only. Lower limb geometry was not associated with muscle function (p > 0.05). Discussion: The ability to alter skeletal geometry via exercise in adulthood appears limited, especially in epiphyseal regions. Furthermore, lower limb geometry does not appear to be associated with muscle function.
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Affiliation(s)
- Matteo Scorcelletti
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
- Werner Siemens-Endowed Chair for Innovative Implant Development (Fracture Healing), Division of Surgery, Saarland University, Homburg, Germany
| | - Jochen Zange
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Jonas Böcker
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Wolfram Sies
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Patrick Lau
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Uwe Mittag
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Neil D. Reeves
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
| | - Alex Ireland
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
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Yoo HJ, Jeong HW, Park SB, Shim SJ, Nam HS, Lee YS. Do Individualized Patient-Specific Situations Predict the Progression Rate and Fate of Knee Osteoarthritis? Prediction of Knee Osteoarthritis. J Clin Med 2023; 12:jcm12031204. [PMID: 36769856 PMCID: PMC9918059 DOI: 10.3390/jcm12031204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Factors affecting the progression rate and fate of osteoarthritis need to be analyzed when considering patient-specific situation. This study aimed to identify the rate of remarkable progression and fate of primary knee osteoarthritis based on patient-specific situations. Between May 2003 and May 2019, 83,280 patients with knee pain were recruited for this study from the clinical data warehouse. Finally, 2492 knees with pain that were followed up for more than one year were analyzed. For analyzing affecting factors, patient-specific information was categorized and classified as demographic, radiologic, social, comorbidity disorders, and surgical intervention data. The degree of contribution of factors to the progression rate and the fate of osteoarthritis was analyzed. Bone mineral density (BMD), Kellgren-Lawrence (K-L) grade, and physical occupational demands were major contributors to the progression rate of osteoarthritis. Hypertension, initial K-L grade, and physical occupational demands were major contributors to the outcome of osteoarthritis. The progression rate and fate of osteoarthritis were mostly affected by the initial K-L grade and physical occupational demands. Patients who underwent surgical intervention for less than five years had the highest proportion of initial K-L grade 2 (49.0%) and occupations with high physical demand (41.3%). In identifying several contributing factors, the initial K-L grade and physical occupational demands were the most important factors. BMD and hypertension were also major contributors to the progression and fate of osteoarthritis, and the degree of contribution was lower compared to the two major factors.
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Affiliation(s)
- Hyun Jin Yoo
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
- Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon 35365, Republic of Korea
| | - Ho Won Jeong
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
| | - Sung Bae Park
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
| | - Seung Jae Shim
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
| | - Hee Seung Nam
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
| | - Yong Seuk Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
- Correspondence: or ; Tel.: +82-31-787-7199; Fax: +82-31-787-4056
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Elsheikh R, Makram AM, Makram OM, Tamer A, Hafez MA. Femoral bowing in the Arab population: A cross-sectional study and literature review. TRANSLATIONAL RESEARCH IN ANATOMY 2022. [DOI: 10.1016/j.tria.2021.100160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Radiographic hand osteoarthritis in women farmers: characteristics and risk factors. Ann Occup Environ Med 2022; 34:e10. [PMID: 35801226 PMCID: PMC9209098 DOI: 10.35371/aoem.2022.34.e10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 12/05/2022] Open
Abstract
Background Repetitive hand use increases the risk of hand osteoarthritis (OA). This study aimed to investigate characteristics of and risk factors for hand OA in Korean women farmers. Methods This cross-sectional study included women farmers resident in Jeollanam-do, Korea. The participants were interviewed, and radiographs were taken of both hands. Radiological hand OA was defined based on the Osteoarthritis Research Society International imaging criteria of joint space narrowing or the presence of osteophytes. The participants were divided into age groups of < 60 and ≥ 60 years. Obesity was defined as body mass index of > 25 kg/m2. Annual working time was divided into < 2,000, 2,000–2,999, and ≥ 3,000 hours. Agricultural working type was divided into rice farming and field farming. Robust Poisson regression was used to identify factors associated with radiographic hand OA, with adjustment for age, obesity, annual working time, and agricultural classification. Results A total of 310 participants with a mean age of 58.1 ± 7.6 years, were enrolled. The prevalence of radiologically confirmed OA was 49.0%, with an OA prevalence of 39.4% the interphalangeal joint in the thumb (IP1). The prevalence of OA was higher in the distal interphalangeal joint than in the proximal interphalangeal, metacarpophalangeal, and carpometacarpal joints. The prevalence of OA varied by age, annual working time, and agriculture type. Conclusions Korean women farmers have a high prevalence of OA, particularly in the IP1 joints. OA is associated with age, working hours, and agriculture type.
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Work-related factors of knee osteoarthritis in Korean farmers: a cross-sectional study. Ann Occup Environ Med 2021; 32:e37. [PMID: 34754458 PMCID: PMC7779842 DOI: 10.35371/aoem.2020.32.e37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/23/2020] [Indexed: 11/20/2022] Open
Abstract
Background Several studies have reported a high prevalence of osteoarthritis (OA) of the knee among agricultural workers. We investigated work-related factors that increase the risk of knee OA among Korean farmers. Methods Data were extracted from the Jeonnam Center for Farmer's Safety and Health survey, conducted between 2013 and 2015. The sample included 489 farmers (man 240, woman 249). We defined knee OA as radiographic knee OA (≥ Kellgren-Lawrence grade 2) with symptoms (≥ Western Ontario and McMaster Universities Osteoarthritis, Korean version score 29.5). We considered covariates such as cumulative squatting working time (CSWT), cumulative heavy lifting working time (CLWT), body mass index (BMI), and history of knee injury. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated for knee OA and adjusted for relevant covariates. Results The results of multivariate logistic regression analysis indicated that knee OA was correlated by factors such as sex, age, BMI, history of knee injury, CSWT, and CLWT. Particularly, CSWT > 20,000 hours (OR: 2.83; 95% CI: 1.35-5.92; reference < 10,000 hours) and CLWT > 5,000 hours (OR: 2.62; 95% CI: 1.14-6.06; reference < 2,000 hours) were associated with an increased risk of knee OA after adjustment for covariates. Conclusions Squatting posture and heavy lifting associated with farm work might increase the risk of knee OA among Korean farmers.
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