Correlation Between the Severity of Knee Osteoarthritis and Alignment Changes
SHI Yanxin
BAI Yu
LUO Xiaofei
MA Fuqiang
Abstract：Objective To investigate the correlation between the severity of knee osteoarthritis(KOA)and changes in lower limb alignment and the microstructure of subchondral bone.Methods Fifty patients diagnosed with KOA in Zhengzhou Orthopedic Hospital and admitted between August 2020 and February 2022 were enrolled,including 19 males and 31 females,aged(68.41±4.23)years,with disease duration(3.52±0.91)years.All patients underwent standard weight-bearing full-length radiographs of the lower limbs to measure the tibiofemoral angle and femoral valgus angle,and were graded according to the Kellgren and Lawrence standard:28 cases were grade Ⅲ,22 cases were grade Ⅳ.All patients received total knee replacement treatment,and tibial plateau specimens were preserved during surgery.The femorotibial angle(FTA),knee physiological valgus angle(KPV),and trabecular bone structural parameters of the medial and lateral tibial plateaus were compared between grade Ⅲ and grade Ⅳ patients.Results All wounds healed without infection or skin necrosis;all patients were followed up for 12 months.The FTA was higher in grade Ⅳ patients than in grade Ⅲ patients,the difference being statistically significant(P＜0.05);there was no statistically significant difference in the KPV between grade Ⅲ and grade Ⅳ (P＞0.05).Trabecular bone volume fraction,trabecular thickness and trabecular number of the medial tibial plateau in grade Ⅲ patients were higher than those in the medial side of grade Ⅳ patients,and trabecular separation was lower than that in the medial side of grade Ⅳ patients,the differences being statistically significant(P＜0.05).Trabecular bone volume fraction,trabecular thickness and trabecular number of the lateral tibial plateau in grade Ⅲ patients were higher than those in the lateral side of grade Ⅳ patients,and trabecular separation was lower than that in the lateral side of grade Ⅳ patients,the differences being statistically significant(P＜0.05).When comparing medial and lateral plateaus within the same period,the difference was statistically significant(P＜0.05).Spearman rank correlation analysis showed that the degree of cartilage degeneration in the tibial plateau of advanced KOA patients was positively correlated with trabecular bone volume fraction,trabecular thickness and trabecular number(r=0.265,0.316,0.158,0.169,P=0.003),and negatively correlated with trabecular separation(r=-0.165,P=0.015).Conclusion The severity of KOA lesions is positively correlated with changes in lower limb alignment,and the changes in alignment are mainly manifested on the tibial side;comparing the trabecular bone structural parameters of the medial and lateral tibial plateaus between grade Ⅲ and grade Ⅳ,the severity of KOA is positively correlated with trabecular bone volume fraction,trabecular thickness and trabecular number,and negatively correlated with microstructural changes in the subchondral bone.
Keywords：knee osteoarthritislower limb alignmenttrabecular changes
Publication Date：2026-08-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：4( 2703-2706 )