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Varus inclination of the tibia is related to patellofemoral osteoarthritis in Japanese female patients with moderate knee osteoarthritis

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to investigate whether the tibial tuberosity–trochlear groove (TT–TG) distance and lateral patellar tilt, which induce patellofemoral osteoarthritis (OA), are related to the coronal deformity of the lower limb in varus knee OA. It was hypothesized that varus inclination of the tibia was negatively correlated with the TT–TG distance and lateral patellar tilt in Japanese female patients with moderate knee OA.

Methods

A total of 104 female patients (139 knees) scheduled to undergo knee osteotomy for varus knee OA were enrolled. The coronal lower limb alignment was measured on anteroposterior whole-leg radiographs. The TT–TG distance, patellar tilt angle, and the patellofemoral joint space were measured both medially and laterally on computed tomography images. The correlations between coronal lower limb alignment and the TT–TG distance or patellar tilt angle, and the correlations between the TT–TG distance or patellar tilt angle and patellofemoral joint space were evaluated.

Results

The medial proximal tibial angle was negatively correlated with the TT–TG distance (r =  − 0.383, P < 0.01) and patellar tilt angle (r =  − 0.34, P < 0.01). Lateral patellofemoral joint space was negatively correlated with the TT–TG distance (r =  − 0.256, P = 0.002) and patellar tilt angle (r =  − 0.205, P = 0.016).

Conclusions

Varus inclination of the proximal tibia may induce lateralization of the tibial tuberosity and lateral patellar tilt. The tibial tuberosity lateralization and lateral patellar tilt may induce lateral patellofemoral OA in patients with varus knee OA.

Level of evidence

III.

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Abbreviations

OA:

Osteoarthritis

TT–TG distance:

Tibial tuberosity–trochlear groove distance

HKA:

Hip–knee–ankle angle

HTO:

High tibial osteotomy

DLO:

Double-level osteotomy

CT:

Computed tomography

mLDFA:

Mechanical lateral distal femoral angle

mMPTA:

Mechanical medial proximal tibial angle

ICCs:

Intraclass correlation coefficients

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Funding

No funding was obtained for this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Shuntaro Nejima, Ken Kumagai, Shunsuke Yamada, Tomotaka Akamatsu, Takahiro Ogino, Masaichi Sotozawa & Yutaka Inaba

  2. Department of Orthopaedic Surgery, Yokohama Medical Center, Yokohama, Japan

    Hideo Kobayashi

Authors
  1. Shuntaro Nejima
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  2. Ken Kumagai
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  3. Hideo Kobayashi
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  4. Shunsuke Yamada
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  5. Tomotaka Akamatsu
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  6. Takahiro Ogino
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  7. Masaichi Sotozawa
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  8. Yutaka Inaba
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Contributions

SN: study design, data collection, interpreting the data, and writing the paper. KK and HK: data collection. SY, TA, TO, MS, and YI: interpretation. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ken Kumagai.

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There are no conflict of interest.

Ethics approval and consent to participate

Ethical approval for the study was obtained from the institutional review board of Yokohama City University Hospital (B190700007). Informed and written consent was obtained from all patients.

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Nejima, S., Kumagai, K., Kobayashi, H. et al. Varus inclination of the tibia is related to patellofemoral osteoarthritis in Japanese female patients with moderate knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 29, 652–658 (2021). https://doi.org/10.1007/s00167-020-06000-w

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  • DOI: https://doi.org/10.1007/s00167-020-06000-w

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