Knee-Spine Syndrome, a Common Presentation in Elderly Patients Who Are Candidate for Knee Arthroplasty: Educational Corner
-
Alireza Moharrami
,
Mohammad Mirahmadi Eraghi
,
Shahabaldin Beheshti Fard
,
Ali Asadifar
,
Ali Salehi
,
Sadulla Sharifpour
,
SM Javad Mortazavi
Abstract
Low back pain (LBP) is a significant issue in both clinical and public health settings, resulting in high healthcare and social costs. While knee joint pain is more prevalent than hip joint pain, standing posture is influenced not only by spinal alignment but also by hip and knee joint alignment. The knee and spine are interconnected anatomically, and degenerative changes in one area could often cause discomfort in the entire axis, leading to what is known as "knee-spine syndrome". LBP is a common condition associated with knee pain and can significantly affect the results of total knee arthroplasty (TKA). Surgeons need to consider knee-spine
syndrome before any surgical intervention in patients with knee or back pain and explain it to the patients before the surgery.
1. Andersson GB. Epidemiology of low back pain. Acta Orthop Scand Suppl. 1998;281:28-31. doi: 10.1080/17453674.1998.11744790. [PubMed: 9771538].
2. Bergenudd H, Nilsson B. The prevalence of locomotor complaints in middle age and their relationship to health and socioeconomic factors. Clin Orthop Relat Res. 1994;(308): 264-70. [PubMed: 7955692].
3. Berlemann U, Jeszenszky DJ, Buhler DW, Harms J. The role of lumbar lordosis, vertebral end-plate inclination, disc height, and facet orientation in degenerative spondylolisthesis. J Spinal Disord. 1999;12(1):68-73. [PubMed: 10078953].
4. Offierski CM, MacNab I. Hip-spine syndrome. Spine (Phila Pa 1976 ). 1983;8(3):316-21. doi: 10.1097/00007632-198304000-00014. [PubMed: 6623198].
5. Chen YL. Vertebral centroid measurement of lumbar lordosis compared with the Cobb technique. Spine (Phila Pa 1976). 1999;24(17):1786-90. doi: 10.1097/00007632-199909010-00007. [PubMed: 10488508].
6. Chernukha KV, Daffner RH, Reigel DH. Lumbar lordosis measurement. A new method versus Cobb technique. Spine (Phila Pa 1976 ). 1998;23(1):74-9. doi: 10.1097/00007632-199801010-00016. [PubMed: 9460156].
7. Jackson RP, McManus AC. Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study. Spine (Phila Pa 1976). 1994;19(14):1611-8. doi: 10.1097/00007632-199407001-00010. [PubMed: 7939998].
8. Oshima Y, Watanabe N, Iizawa N, Majima T, Kawata M, Takai S. Knee-Hip-Spine Syndrome: Improvement in Preoperative Abnormal Posture following Total Knee Arthroplasty. Adv Orthop. 2019;2019:8484938. doi: 10.1155/2019/8484938. [PubMed: 31355006]. [PubMed Central: PMC6634073].
9. Lee CS, Park SJ, Chung SS, Lee KH. The effect of simulated knee flexion on sagittal spinal alignment: novel interpretation of spinopelvic alignment. Eur Spine J. 2013;22(5):1059-65. doi: 10.1007/s00586-013-2661-4. [PubMed: 23338541]. [PubMed Central: PMC3657059].
10. Govil G, Tomar L, Dhawan P. Knee-Spine Syndrome: Management Dilemma When Knee Osteoarthritis Coexists With Spine Degeneration. Cureus. 2022;14(5):e24939. doi: 10.7759/cureus.24939. [PubMed: 35698678]. [PubMed Central: PMC9187136].
11. Tsuji T, Matsuyama Y, Goto M, Yimin Y, Sato K, Hasegawa Y, et al. Knee-spine syndrome: correlation between sacral inclination and patellofemoral joint pain. J Orthop Sci. 2002;7(5):519-23. doi: 10.1007/s007760200092. [PubMed: 12355123].
12. Goodman SB, Lachiewicz PF, Liu N, Wood KB. Knee or spine surgery first? A survey of treatment order for patients with concurrent degenerative knee and lumbar spinal disorders. J Arthroplasty. 2020;35(8):2039-43. doi: 10.1016/j.arth.2020.03.018. [PubMed: 32247672].
13. Londhe SB, Shah RV, Patwardhan M, Doshi AP, Londhe SS, Subhedar K, et al. Study of patients with bilateral knee osteoarthritis undergoing total knee replacement procedure with coexisting lumbar spondylosis symptoms. Asian Spine J. 2021;15(6):825-30. doi: 10.31616/asj.2020.0279. [PubMed: 33355851]. [PubMed Central: PMC8696049].
14. Okamoto Y, Wakama H, Okayoshi T, Matsuyama J, Otsuki S, Neo M. Spinopelvic mismatch is associated with patient-reported outcome measures after total knee arthroplasty at a mean follow-up of 15 years. Knee. 2022;34:156-66. doi: 10.1016/j.knee.2021.11.017. [PubMed: 34923348].
15. Kitagawa A, Yamamoto J, Toda M, Hashimoto Y. Spinopelvic alignment and low back pain before and after total knee arthroplasty. Asian Spine J. 2021;15(1):9-16. doi: 10.31616/asj.2019.0359. [PubMed: 32693445]. [PubMed Central: PMC7904480].
16. Carey TS, Garrett J. Patterns of ordering diagnostic tests for patients with acute low back pain. The North Carolina Back Pain Project. Ann Intern Med. 1996;125(10):807-14. doi: 10.7326/0003- 4819-125-10-199611150-00004]. [PubMed: 8928987].
17. Carey TS, Evans A, Hadler N, Kalsbeek W, McLaughlin C, Fryer J. Care-seeking among individuals with chronic low back pain. Spine (Phila Pa 1976). 1995;20(3):312-7. doi: 10.1097/00007632- 199502000-00009. [PubMed: 7732467].
18. Kent DL, Larson EB. Disease, level of impact, and quality of research methods. Three dimensions of clinical efficacy assessment applied to magnetic resonance imaging. Invest Radiol. 1992;27(3):245-54. doi: 10.1097/00004424-199203000- 00014. [PubMed: 1551777].
19. Nair S, Podichetty VK. The preoperative and postoperative assessment and care of patients with back pain. Neurol Clin. 2004;22(2):441-56. doi: 10.1016/j.ncl.2003.12.003. [PubMed: 15062522].
2. Bergenudd H, Nilsson B. The prevalence of locomotor complaints in middle age and their relationship to health and socioeconomic factors. Clin Orthop Relat Res. 1994;(308): 264-70. [PubMed: 7955692].
3. Berlemann U, Jeszenszky DJ, Buhler DW, Harms J. The role of lumbar lordosis, vertebral end-plate inclination, disc height, and facet orientation in degenerative spondylolisthesis. J Spinal Disord. 1999;12(1):68-73. [PubMed: 10078953].
4. Offierski CM, MacNab I. Hip-spine syndrome. Spine (Phila Pa 1976 ). 1983;8(3):316-21. doi: 10.1097/00007632-198304000-00014. [PubMed: 6623198].
5. Chen YL. Vertebral centroid measurement of lumbar lordosis compared with the Cobb technique. Spine (Phila Pa 1976). 1999;24(17):1786-90. doi: 10.1097/00007632-199909010-00007. [PubMed: 10488508].
6. Chernukha KV, Daffner RH, Reigel DH. Lumbar lordosis measurement. A new method versus Cobb technique. Spine (Phila Pa 1976 ). 1998;23(1):74-9. doi: 10.1097/00007632-199801010-00016. [PubMed: 9460156].
7. Jackson RP, McManus AC. Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study. Spine (Phila Pa 1976). 1994;19(14):1611-8. doi: 10.1097/00007632-199407001-00010. [PubMed: 7939998].
8. Oshima Y, Watanabe N, Iizawa N, Majima T, Kawata M, Takai S. Knee-Hip-Spine Syndrome: Improvement in Preoperative Abnormal Posture following Total Knee Arthroplasty. Adv Orthop. 2019;2019:8484938. doi: 10.1155/2019/8484938. [PubMed: 31355006]. [PubMed Central: PMC6634073].
9. Lee CS, Park SJ, Chung SS, Lee KH. The effect of simulated knee flexion on sagittal spinal alignment: novel interpretation of spinopelvic alignment. Eur Spine J. 2013;22(5):1059-65. doi: 10.1007/s00586-013-2661-4. [PubMed: 23338541]. [PubMed Central: PMC3657059].
10. Govil G, Tomar L, Dhawan P. Knee-Spine Syndrome: Management Dilemma When Knee Osteoarthritis Coexists With Spine Degeneration. Cureus. 2022;14(5):e24939. doi: 10.7759/cureus.24939. [PubMed: 35698678]. [PubMed Central: PMC9187136].
11. Tsuji T, Matsuyama Y, Goto M, Yimin Y, Sato K, Hasegawa Y, et al. Knee-spine syndrome: correlation between sacral inclination and patellofemoral joint pain. J Orthop Sci. 2002;7(5):519-23. doi: 10.1007/s007760200092. [PubMed: 12355123].
12. Goodman SB, Lachiewicz PF, Liu N, Wood KB. Knee or spine surgery first? A survey of treatment order for patients with concurrent degenerative knee and lumbar spinal disorders. J Arthroplasty. 2020;35(8):2039-43. doi: 10.1016/j.arth.2020.03.018. [PubMed: 32247672].
13. Londhe SB, Shah RV, Patwardhan M, Doshi AP, Londhe SS, Subhedar K, et al. Study of patients with bilateral knee osteoarthritis undergoing total knee replacement procedure with coexisting lumbar spondylosis symptoms. Asian Spine J. 2021;15(6):825-30. doi: 10.31616/asj.2020.0279. [PubMed: 33355851]. [PubMed Central: PMC8696049].
14. Okamoto Y, Wakama H, Okayoshi T, Matsuyama J, Otsuki S, Neo M. Spinopelvic mismatch is associated with patient-reported outcome measures after total knee arthroplasty at a mean follow-up of 15 years. Knee. 2022;34:156-66. doi: 10.1016/j.knee.2021.11.017. [PubMed: 34923348].
15. Kitagawa A, Yamamoto J, Toda M, Hashimoto Y. Spinopelvic alignment and low back pain before and after total knee arthroplasty. Asian Spine J. 2021;15(1):9-16. doi: 10.31616/asj.2019.0359. [PubMed: 32693445]. [PubMed Central: PMC7904480].
16. Carey TS, Garrett J. Patterns of ordering diagnostic tests for patients with acute low back pain. The North Carolina Back Pain Project. Ann Intern Med. 1996;125(10):807-14. doi: 10.7326/0003- 4819-125-10-199611150-00004]. [PubMed: 8928987].
17. Carey TS, Evans A, Hadler N, Kalsbeek W, McLaughlin C, Fryer J. Care-seeking among individuals with chronic low back pain. Spine (Phila Pa 1976). 1995;20(3):312-7. doi: 10.1097/00007632- 199502000-00009. [PubMed: 7732467].
18. Kent DL, Larson EB. Disease, level of impact, and quality of research methods. Three dimensions of clinical efficacy assessment applied to magnetic resonance imaging. Invest Radiol. 1992;27(3):245-54. doi: 10.1097/00004424-199203000- 00014. [PubMed: 1551777].
19. Nair S, Podichetty VK. The preoperative and postoperative assessment and care of patients with back pain. Neurol Clin. 2004;22(2):441-56. doi: 10.1016/j.ncl.2003.12.003. [PubMed: 15062522].
| Files | ||
| Issue | Vol 10 No 4 (2024) | |
| Section | Educational Corner | |
| DOI | https://doi.org/10.18502/jost.v10i4.17369 | |
| Keywords | ||
| Low Back Pain Knee Spine Syndrome Patellofemoral Pain Syndrome | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Moharrami A, Mirahmadi Eraghi M, Beheshti Fard S, Asadifar A, Salehi A, Sharifpour S, Mortazavi SJ. Knee-Spine Syndrome, a Common Presentation in Elderly Patients Who Are Candidate for Knee Arthroplasty: Educational Corner. J Orthop Spine Trauma. 2024;10(4):170-3.
