The impact of body-mass index on the frontal knee alignment estimation using three-dimensional reconstruction based on movement analysis.

BACKGROUND We evaluated the influence of the body-mass index (BMI) on the estimation of the static frontal knee alignment (FKA) using three-dimensional (3D) reconstruction method based on movement analysis. METHODS Two-hundred nineteen knees (120 individuals with end-stage osteoarthritis) were analyzed. The validity of the 3D method was evaluated under comparison with a reference method based on weight bearing full-leg length radiography. Extensive statistical analyses (Pearson's correlation, one-way ANOVA, linear regression, boxplot diagram) over four groups of BMI (normal, overweight, obese class I and obese classes II and III) were performed. RESULTS For BMI below 25 kg/m2, the validity of the 3D method was confirmed. For BMI over 25 kg/m2, there was an increasing error of the 3D method, especially for the obese groups affected with a large varus alignment. CONCLUSIONS In a biomechanical context of movement analysis, the results of the study suggest that the 3D method may represent a satisfying alternative to the full-leg radiograph method with limitations regarding to BMI over 25 kg/m2.

[1]  Benedicte Vanwanseele,et al.  Frontal Knee Alignment: Three-dimensional Marker Positions and Clinical Assessment , 2009, Clinical orthopaedics and related research.

[2]  T. Andriacchi.  Dynamics of knee malalignment. , 1994, The Orthopedic clinics of North America.

[3]  A. Cappozzo,et al.  Human movement analysis using stereophotogrammetry. Part 2: instrumental errors. , 2004, Gait & posture.

[4]  J. Lynch,et al.  Does measurement of the anatomic axis consistently predict hip-knee-ankle angle (HKA) for knee alignment studies in osteoarthritis? Analysis of long limb radiographs from the multicenter osteoarthritis (MOST) study. , 2011, Osteoarthritis and cartilage.

[5]  R. B. Davis,et al.  A gait analysis data collection and reduction technique , 1991 .

[6]  M. Oberst,et al.  Regression and correlation analysis of preoperative versus intraoperative assessment of axes during navigated total knee arthroplasty , 2006, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[7]  Tran Quoc Bao,et al.  Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants , 2016, The Lancet.

[8]  K Bo Foreman,et al.  In-vivo quantification of dynamic hip joint center errors and soft tissue artifact. , 2016, Gait & posture.

[9]  L. Sharma,et al.  The role of knee alignment in disease progression and functional decline in knee osteoarthritis. , 2001, JAMA.

[10]  Lorenzo Chiari,et al.  Human movement analysis using stereophotogrammetry. Part 4: assessment of anatomical landmark misplacement and its effects on joint kinematics. , 2005, Gait & posture.

[11]  Morgan Sangeux,et al.  Predicting the location of the hip joint centres, impact of age group and sex , 2016, Scientific Reports.

[12]  L. Sharma,et al.  The mechanism of the effect of obesity in knee osteoarthritis: the mediating role of malalignment. , 2000, Arthritis and rheumatism.

[13]  W. Skalli,et al.  Which method of hip joint centre localisation should be used in gait analysis? , 2014, Gait & posture.

[14]  S David Stulberg,et al.  Radiographic and Navigation Measurements of TKA Limb Alignment Do Not Correlate , 2008, Clinical orthopaedics and related research.

[15]  T. Andriacchi,et al.  Interaction between active and passive knee stabilizers during level walking , 1991, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[16]  A Cappozzo,et al.  Soft tissue displacement over pelvic anatomical landmarks during 3-D hip movements. , 2017, Journal of biomechanics.

[17]  T. Andriacchi,et al.  The knee adduction moment during gait in subjects with knee osteoarthritis is more closely correlated with static alignment than radiographic disease severity, toe out angle and pain , 2002, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[18]  F. Cicuttini,et al.  Obesity: a preventable risk factor for large joint osteoarthritis which may act through biomechanical factors , 2004, British Journal of Sports Medicine.

[19]  J. Hintze,et al.  Violin plots : A box plot-density trace synergism , 1998 .

[20]  A. Cappozzo,et al.  Human movement analysis using stereophotogrammetry. Part 3. Soft tissue artifact assessment and compensation. , 2005, Gait & posture.

[21]  A. Astrup,et al.  Obesity : Preventing and managing the global epidemic , 2000 .

[22]  K. Turcot,et al.  Knee Kinematic and Clinical Outcomes Evolution Before, 3 Months, and 1 Year After Total Knee Arthroplasty. , 2017, The Journal of arthroplasty.

[23]  M. Minor,et al.  Measurement of varus/valgus alignment in obese individuals with knee osteoarthritis , 2010, Arthritis care & research.