Gender affects spine-pelvic-lower limb force line:A cross-sectional imaging study of knee osteoarthritis

Abstract

Objective:The aim of this study was to investigate the relationship between imaging indicators of knee osteoarthritis and the presence of gender orientation and risk factors. Methods:This study retrospectively included 318 patients with knee osteoarthritis.Based on Kellgren-Lawrence(KL)scoring system,These patients were classified as having limited knee osteoarthritis(LKOA) and severe knee osteoarthritis(SLOA).We measured the lumbar lordosis angle(LL),sacral slope angle(SS),pelvic incidence angle(PI),the mechanical axis deviation(MAD),Joint line convergence angle(JLCA) and lateral proximal femur angle(LPFA) in each patient to explore whether the correlation between these parameters is correlation under different gender conditions. Results:The study showed that in LKOA group,JLCA in female patients showed significant negative correlation with PI and LL(P<0.01),while SS in male patients showed significant positive correlation with MAD and LPFA(P<0.01).Multiple linear regression analysis revealed that PI was an independent risk factor for JLCA in female patients.In male patients,SS is an independent risk factor for MAD.However, in the SKOA group, there was no significant correlation between JLCA,MAD and LL,SS and PI in either male or female (P>0.05),suggesting that gender had less influence on the relationship between these parameters in the more severe stage of the disease. Conclusion:There were differences between lumbar vertebrae-pelvic parameters and knee line of force in patients with limited knee osteoarthritis of different genders.The JLCA was associated with Pelvic retroversion and straightening of lumbar curvature in women,while the shift of mechanical axis deviation was associated with Pelvis forward in men.In patients with severe knee osteoarthritis,lumbar-pelvic parameters were not associated with knee line of force,and gender differences disappeared.