Physical activity after distal femur osteotomy for the treatment of lateral compartment knee osteoarthritis

The risk of non-union and prolonged periods of protected weight-bearing still remain unsolved issues after distal femur osteotomy (DFO). To improve the stability, we developed the double chevron-cut technique, which is a modified medial closing-wedge DFO guided by a patient-specific instrument. The purpose of this study was to investigate the feasibility and outcome of this operative approach. Twenty-five knees in twenty-three consecutive patients with genu valgum and lateral compartment osteoarthritis that received double chevron-cut DFO were included. The target of correction was 50% on the weight-bearing line (WBL) ratio. Patient-reported outcomes included the Oxford Knee Score (OKS) and the 2011 Knee Society Score (KSS). The mean of the WBL ratio was corrected from 78.7% ± 12.0% to 48.7% ± 2.9% postoperatively. The mean time to full weight bearing was 3.7 ± 1.4 weeks. Union of the osteotomy was achieved at 11.3 ± 2.8 weeks. At a mean follow-up of 17 months, the OKS improved from a mean of 27.6 ± 11.7 to 39.1 ± 7.5 (p = 0.03), and the KSS from a mean of 92.1 ± 13.0 to 143.9 ± 10.2 (p < 0.001). Three patients developed complications, including one case of peri-implant fracture, one of loss of fixation, and one of non-union. The double chevron-cut DFO followed by immediate weight-bearing as tolerated is effective in treating genu valgum deformity and associated lateral compartment osteoarthritis.

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Risk Factors for Radiographic Tibiofemoral Knee Osteoarthritis: The Wuchuan Osteoarthritis Study

International Journal of Rheumatology ◽

10.1155/2010/385826 ◽

2010 ◽

Vol 2010 ◽

pp. 1-6 ◽

Cited By ~ 9

Author(s):

Jianhao Lin ◽

Rujun Li ◽

Xiaozheng Kang ◽

Hu Li

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Knee Osteoarthritis ◽

Weight Bearing ◽

Lateral Compartment ◽

Activity Level ◽

Medial Compartment ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Knee Oa

Objective. To investigate the risk factors of radiographic tibiafemoral knee osteoarthritis (OA).Methods. A population-based cross-sectional survey was conducted in Wuchuan County. A questionnaire and bilateral weight-bearing posterior-anterior semi-flexed knee radiographs were completed and read for Kellgren and Lawrence (K/L) grade and joint space narrowing (JSN; 0–3 scale) in each compartment. An logistic regression analysis was performed for radiographic tibiafemoral, lateral compartment, and medial compartment knee OA, respectively. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated.Results. Age, sex, and knee injury were strongly associated with tibiafemoral, lateral and medial compartment knee OA. BMI also had a dose-response relationship with them. Physical activity level, and physical activity exposure at work, not significantly though, were associated with an elevated risk for this three kinds of knee OA.Conclusions. Physical activity exposure increased the risk of knee OA. It was likely to be the heavier physical activity in Wuchuan osteoarthritis study that counteracted the BMI gap compared with the Beijing and the Framingham OA study. We verified that Chinese had a more valgus alignment of the knee compared with Caucasian population, and this provide a possible explanation why Chinese have a higher prevalence of lateral compartment OA.

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The Results of Patient-Specific Instrument Guided Chevron-cut Distal Femur Osteotomy: A Retrospective Analysis

10.21203/rs.3.rs-142034/v1 ◽

2021 ◽

Author(s):

Kuan-Jung Chen ◽

Kuan-Yu Lin ◽

Yen-Chun Huang ◽

Oscar Kuang-Sheng Lee ◽

Jesse Chieh-Szu Yang

Keyword(s):

Distal Femur ◽

Weight Bearing ◽

Lateral Compartment ◽

Pain Scale ◽

Genu Valgum ◽

Patient Specific ◽

Non Union ◽

Specific Instrument ◽

Distal Femur Osteotomy ◽

Patient Reported

Abstract BackgroundDistal femur osteotomy (DFO) has been gaining popularity in treating subjects with genu valgum and the associated lateral compartment osteoarthritis. However, the risk of non-union and a period of protective weight bearing still remain unsolved even with the advent of locking plates. To improve the inherent stability of medial close-wedge DFO, we create bone cut in chevron shape with the guidance of a patient-specific instrument (PSI). The patients were allowed immediate weight-bearing as tolerated. The objective of the study was to assess the results of this technique.MethodsTwenty-five knees in twenty-three consecutive patients with genu valgum and lateral compartment osteoarthritis received chevron-cut medial close-wedge DFO. The alignment parameters of the knee, including the weight-bearing line (WBL) ratio, hip-knee-ankle angle (HKA), and mechanical lateral distal femoral angle (mLDFA) were assessed. We defined outliers as those with a difference of more than 10% from the targeted 50% WBL ratio. Patient-reported evaluation included the Oxford Knee Score (OKS), Knee Society Score (KSS), and a visual analog scale (VAS) pain scale.ResultsThe WBL ratio, HKA, and mLDFA were corrected from a mean of 78.7% ± 12.0%, 9.3° ± 2.8° valgus, and 83.6° ± 1.9° to 48.7% ± 2.9%, 0.5° ± 1.1° varus, and 91.4° ± 3.5° (respectively) postoperatively. A mean operative time of 58.8 ± 18.3 minutes, and 6.2 ± 1.3 intraoperative radiographs were taken. A mean Hb drop of 1.4 g/dl was found, while no patient required transfusion. Only one knee (4%) postoperatively fell in the defined range of correction outliers. Consolidation of the osteotomy was achieved at 11.3 ± 2.8 weeks. The OKS, KSS, and VAS pain scale were significantly improved compared with the pre-operative data. Complications developed in three patients, including one periprosthetic fracture, one loss of fixation, and a case of non-union.ConclusionThe PSI-guided chevron-cut close-wedge DFO, followed by immediate weight-bearing as tolerated is accurate, safe, and effective in the correction of genu valgum deformity and the associated lateral compartment osteoarthritis.Level of evidence IV

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Experiences of persons with knee osteoarthritis using a wearable-enabled intervention involving counselling by a physiotherapist to support physical activity: a secondary analysis using an ethics lens

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2020.02.049 ◽

2020 ◽

Vol 28 ◽

pp. S30-S31

Author(s):

J. Leese ◽

G.G. MacDonald ◽

A.F. Townsend ◽

C.L. Backman ◽

L. Nimmon ◽

...

Keyword(s):

Physical Activity ◽

Knee Osteoarthritis ◽

Secondary Analysis

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Novel use of accelerometry data to develop phenotypes of free-living physical activity (performance) and differentiate between knee osteoarthritis, lumbar spinal stenosis, and healthy populations

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2016.01.777 ◽

2016 ◽

Vol 24 ◽

pp. S430

Author(s):

C. Tomkins-Lane ◽

J. Norden ◽

A. Sinha ◽

R. Hu ◽

M. Smuck

Keyword(s):

Physical Activity ◽

Knee Osteoarthritis ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Free Living ◽

Activity Performance ◽

Lumbar Spinal

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Daily Spousal Influence on Physical Activity in Knee Osteoarthritis

Annals of Behavioral Medicine ◽

10.1007/s12160-012-9442-x ◽

2012 ◽

Vol 45 (2) ◽

pp. 213-223 ◽

Cited By ~ 41

Author(s):

Lynn M. Martire ◽

Mary Ann Parris Stephens ◽

Jacqueline Mogle ◽

Richard Schulz ◽

Jennifer Brach ◽

...

Keyword(s):

Physical Activity ◽

Knee Osteoarthritis ◽

Spousal Influence

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Group-mediated Physical Activity Promotion and Mobility in Sedentary Patients with Knee Osteoarthritis: Results from the IMPACT-Pilot Trial

The Journal of Rheumatology ◽

10.3899/jrheum.140054 ◽

2014 ◽

Vol 41 (10) ◽

pp. 2068-2077 ◽

Cited By ~ 12

Author(s):

Brian C. Focht ◽

Matthew J. Garver ◽

Steven T. Devor ◽

Justin Dials ◽

Alexander R. Lucas ◽

...

Keyword(s):

Physical Activity ◽

Knee Osteoarthritis ◽

Exercise Intervention ◽

Pilot Trial ◽

Physical Activity Promotion ◽

Knee Oa ◽

Activity Promotion ◽

Favorable Change ◽

Intent To Treat ◽

The Impact

Objective.To compare the effects of a group-mediated cognitive behavioral exercise intervention (GMCB) with traditional center-based exercise therapy (TRAD) on objectively assessed levels of physical activity (PA) and mobility in sedentary patients with knee osteoarthritis (OA).Methods.The Improving Maintenance of Physical Activity in Knee Osteoarthritis Trial-Pilot (IMPACT-P) was a 12-month, 2-arm, single-blind, randomized controlled pilot study designed to compare the effects of GMCB and TRAD on 80 sedentary patients with knee OA with self-reported difficulty in daily activities [mean age 63.5 yrs, 84% women, mean body mass index (BMI) 32.7 kg/m2]. Objective assessments of PA (LIFECORDER Plus Accelerometer) and mobility (400-m walk) were obtained at baseline, 3 months, and 12 months by study personnel blinded to participants’ treatment assignment.Results.Intent to treat 2 (treatment: GMCB and TRAD) × 2 (time: 3 mos and 12 mos) analyses of covariance of controlling for baseline, age, sex, and BMI-adjusted change in the outcomes demonstrated that the GMCB intervention yielded significantly greater increases in PA (p < 0.01) and a nonsignificant yet more favorable improvement in mobility (p = 0.09) relative to TRAD. Partial correlation analyses also revealed that change in PA was significantly correlated with the 400-m walk performance at 3-month (r = −0.51, p < 0.01) and 12-month (r = −0.40, p < 0.01) followup assessments.Conclusion.Findings from the IMPACT-P trial suggest that the GMCB treatment resulted in significantly greater improvement in PA and nonsignificant yet more favorable change in mobility relative to TRAD.

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