Abstract
Background
Total hip arthroplasty decreases hip pain and often reduces knee pain in patients
with hip osteoarthritis. Whole-body alignment may be associated with knee pain, but
to our knowledge this relationship has not been previously investigated. The purpose
of this study was to investigate the effect of changes in whole-body alignment on
ipsilateral knee pain in patients after total hip arthroplasty.
Methods
In total, 94 patients with unilateral hip osteoarthritis who underwent total hip arthroplasty
were enrolled in this study. A visual analog scale (VAS) was used to investigate perioperative
knee pain. An EOS 2D/3D X-ray system was used to quantify the whole-body alignment
of the spine, pelvis, and lower extremities in the standing position. The relationship
between perioperative changes in knee pain and whole-body alignment was investigated.
Results
Among 61 patients who had preoperative ipsilateral knee pain, pain resolved in 30
(50%) and persisted in 31 (50%) after surgery. In these patients, average ipsilateral
knee pain decreased significantly after surgery, from 41 mm to 14 mm on the VAS (P < 0.01). Preoperative knee pain was correlated with femorotibial rotation, and postoperative
knee pain was correlated with K-L grade, preoperative knee pain visualized analog
scale, and preoperative sagittal vertical axis. Multiple linear regression identified
preoperative sagittal vertical axis as significantly associated with residual postoperative
ipsilateral knee pain.
Conclusions
Ipsilateral knee pain decreased in half of patients after total hip arthroplasty.
Patients with a considerable forward-bent posture may have residual ipsilateral knee
pain after total hip arthroplasty.
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Article info
Publication history
Published online: January 04, 2022
Accepted:
December 10,
2021
Received in revised form:
December 1,
2021
Received:
May 15,
2021
Identification
Copyright
© 2022 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
