Evidence map›Paper›PMID 30415388›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019

Lower limb alignment becomes more varus and hyperextended from supine to bipedal stance in asymptomatic, osteoarthritic and prosthetic neutral or varus knees.

Michael J C Brown, Angela H Deakin, Frederic Picard, Philip E Riches, Jon V Clarke

Open access · hybridAbstract read
In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.2field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Michael J C BrownDepartment of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, West Dunbartonshire, Clydebank, G81 4DY, UK. michaelbrown3@nhs.net.ORCID http://orcid.org/0000-0002-0544-7448
Angela H DeakinDepartment of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, West Dunbartonshire, Clydebank, G81 4DY, UK.
Frederic PicardDepartment of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, West Dunbartonshire, Clydebank, G81 4DY, UK.
Philip E RichesDepartment of Biomedical Engineering, University of Strathclyde, Glasgow, G4 0NW, Scotalnd, UK.
Jon V ClarkeDepartment of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, West Dunbartonshire, Clydebank, G81 4DY, UK.
Golden Jubilee National Hospital · GBUniversity of Strathclyde · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeKnee alignment is a fundamental measurement in the assessment, monitoring and surgical management of patients with osteoarthritis. There is a lack of data regarding how static tibiofemoral alignment varies between supine and standing conditions. This study aimed to quantify the relationship between supine and standing lower limb alignment in asymptomatic, osteoarthritic (OA) and prosthetic (TKA) knees.

methodsA non-invasive position capture system was used to assess knee alignment for 30 asymptomatic controls and 31 patients with OA both before and after TKA. Coronal and sagittal mechanical femorotibial angles were measured supine with the lower limb in extension and in bipedal stance. Changes between conditions were analysed using paired ttests. Vector plots of ankle centre displacement relative to the knee centre from supine to standing were produced to allow three-dimensional visualisation.

resultsAll groups showed a trend towards varus and extension when going from supine to standing. Mean change for asymptomatic knees was 1.2° more varus (p = 0.001) and 3.8° more extended (p < 0.001). For OA knees this was 1.1° more varus (p = 0.009) and 5.9° more extended (p < 0.001) and TKA knees 1.9° more varus (p < 0.001) and 5.6° more extended (p < 0.001).

conclusionThe observed consistent changes in lower limb alignment between supine and standing positions across knee types suggests the soft tissue envelope restraining the knee may have a greater influence on dynamic alignment changes than the underlying bony deformity. This highlights the importance of quantifying soft tissue behaviour when planning, performing and evaluating alignment dependent surgical interventions of the knee. When routinely assessing any type of knee, clinicians should be aware that subtle consistent alignment changes occur under weightbearing conditions and tailor their treatments accordingly. LEVEL OF EVIDENCE: II.

Indexed as

Knee ProsthesisPostureWalkingWeight-BearingAdultAgedAged, 80 and overAnkle JointArthroplasty, Replacement, KneeCase-Control StudiesFemaleHumansKneeKnee JointMaleMiddle AgedBipedal stanceInfrared trackingLower limb alignmentNoninvasiveSupineTibiofemoralTotal knee arthroplastyWeight-bearing

Identifiers

PMID30415388
PMCPMC6527790
OpenAlexW2899547192

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.