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Valgus Arthritic Knee Responds Better to Conservative Treatment than the Varus Arthritic Knee

Background and Objectives: Clinically, it is beneficial to determine the knee osteoarthritis (OA) subtype that responds well to conservative treatments. Therefore, this study aimed to determine the differences between varus and valgus arthritic knees in the response to conservative treatment. We hyp...

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Autores principales: Lee, SeungHoon, Choi, YunSeong, Lee, JaeHyuk, Lee, HeeDong, Yoon, JungRo, Chang, ChongBum
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146304/
https://www.ncbi.nlm.nih.gov/pubmed/37109737
http://dx.doi.org/10.3390/medicina59040779
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author Lee, SeungHoon
Choi, YunSeong
Lee, JaeHyuk
Lee, HeeDong
Yoon, JungRo
Chang, ChongBum
author_facet Lee, SeungHoon
Choi, YunSeong
Lee, JaeHyuk
Lee, HeeDong
Yoon, JungRo
Chang, ChongBum
author_sort Lee, SeungHoon
collection PubMed
description Background and Objectives: Clinically, it is beneficial to determine the knee osteoarthritis (OA) subtype that responds well to conservative treatments. Therefore, this study aimed to determine the differences between varus and valgus arthritic knees in the response to conservative treatment. We hypothesized that valgus arthritic knees would respond better to conservative treatment than varus arthritic knees. Materials and Methods: Medical records of 834 patients who received knee OA treatment were retrospectively reviewed. Patients with Kellgren–Lawrence grades III and IV were divided into two groups according to knee alignment (varus arthritic knee, hip-knee-ankle angle [HKA] > 0° or valgus arthritic knee, HKA < 0°). The Kaplan–Meier curve with total knee arthroplasty (TKA) as an endpoint was used to compare the survival probability between varus and valgus arthritic knees at one, two, three, four, and five years after the first visit. A receiver operating characteristic (ROC) curve was used to compare the HKA thresholds for TKA between varus and valgus arthritic knees. Results: Valgus arthritic knees responded better to conservative treatment than varus arthritic knees. With TKA as an endpoint, the survival probabilities for varus and valgus arthritic knees were 24.2% and 61.4%, respectively, at the 5-year follow-up (p < 0.001). The thresholds of HKA for varus and valgus arthritic knees for TKA were 4.9° and −8.1°, respectively (varus: area under the ROC curve [AUC] = 0.704, 95% confidence interval [CI] 0.666–0.741, p < 0.001, sensitivity = 0.870, specificity = 0.524; valgus: AUC = 0.753, 95% CI 0.693–0.807, p < 0.001, sensitivity = 0.753, specificity = 0.786). Conclusions: Conservative treatment is more effective for valgus than for varus arthritic knees. This should be considered when explaining the prognosis of conservative treatment for knees with varus and valgus arthritis.
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spelling pubmed-101463042023-04-29 Valgus Arthritic Knee Responds Better to Conservative Treatment than the Varus Arthritic Knee Lee, SeungHoon Choi, YunSeong Lee, JaeHyuk Lee, HeeDong Yoon, JungRo Chang, ChongBum Medicina (Kaunas) Article Background and Objectives: Clinically, it is beneficial to determine the knee osteoarthritis (OA) subtype that responds well to conservative treatments. Therefore, this study aimed to determine the differences between varus and valgus arthritic knees in the response to conservative treatment. We hypothesized that valgus arthritic knees would respond better to conservative treatment than varus arthritic knees. Materials and Methods: Medical records of 834 patients who received knee OA treatment were retrospectively reviewed. Patients with Kellgren–Lawrence grades III and IV were divided into two groups according to knee alignment (varus arthritic knee, hip-knee-ankle angle [HKA] > 0° or valgus arthritic knee, HKA < 0°). The Kaplan–Meier curve with total knee arthroplasty (TKA) as an endpoint was used to compare the survival probability between varus and valgus arthritic knees at one, two, three, four, and five years after the first visit. A receiver operating characteristic (ROC) curve was used to compare the HKA thresholds for TKA between varus and valgus arthritic knees. Results: Valgus arthritic knees responded better to conservative treatment than varus arthritic knees. With TKA as an endpoint, the survival probabilities for varus and valgus arthritic knees were 24.2% and 61.4%, respectively, at the 5-year follow-up (p < 0.001). The thresholds of HKA for varus and valgus arthritic knees for TKA were 4.9° and −8.1°, respectively (varus: area under the ROC curve [AUC] = 0.704, 95% confidence interval [CI] 0.666–0.741, p < 0.001, sensitivity = 0.870, specificity = 0.524; valgus: AUC = 0.753, 95% CI 0.693–0.807, p < 0.001, sensitivity = 0.753, specificity = 0.786). Conclusions: Conservative treatment is more effective for valgus than for varus arthritic knees. This should be considered when explaining the prognosis of conservative treatment for knees with varus and valgus arthritis. MDPI 2023-04-17 /pmc/articles/PMC10146304/ /pubmed/37109737 http://dx.doi.org/10.3390/medicina59040779 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, SeungHoon
Choi, YunSeong
Lee, JaeHyuk
Lee, HeeDong
Yoon, JungRo
Chang, ChongBum
Valgus Arthritic Knee Responds Better to Conservative Treatment than the Varus Arthritic Knee
title Valgus Arthritic Knee Responds Better to Conservative Treatment than the Varus Arthritic Knee
title_full Valgus Arthritic Knee Responds Better to Conservative Treatment than the Varus Arthritic Knee
title_fullStr Valgus Arthritic Knee Responds Better to Conservative Treatment than the Varus Arthritic Knee
title_full_unstemmed Valgus Arthritic Knee Responds Better to Conservative Treatment than the Varus Arthritic Knee
title_short Valgus Arthritic Knee Responds Better to Conservative Treatment than the Varus Arthritic Knee
title_sort valgus arthritic knee responds better to conservative treatment than the varus arthritic knee
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146304/
https://www.ncbi.nlm.nih.gov/pubmed/37109737
http://dx.doi.org/10.3390/medicina59040779
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