Knee–Hip–Spine Syndrome: Improvement in Preoperative Abnormal Posture following Total Knee Arthroplasty

An ergonomic upright body posture is maintained by the alignment of the spine, pelvis, and lower extremities, and the muscle strength of body trunk and lower extremities. The posture varies with age because of the degenerative changes in the involved structures and the weakening of the muscles. The...

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Main Authors: Yasushi Oshima, Nobuyoshi Watanabe, Norishige Iizawa, Tokifumi Majima, Mitsuhiro Kawata, Shinro Takai
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Advances in Orthopedics
Online Access:http://dx.doi.org/10.1155/2019/8484938
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author Yasushi Oshima
Nobuyoshi Watanabe
Norishige Iizawa
Tokifumi Majima
Mitsuhiro Kawata
Shinro Takai
author_facet Yasushi Oshima
Nobuyoshi Watanabe
Norishige Iizawa
Tokifumi Majima
Mitsuhiro Kawata
Shinro Takai
author_sort Yasushi Oshima
collection DOAJ
description An ergonomic upright body posture is maintained by the alignment of the spine, pelvis, and lower extremities, and the muscle strength of body trunk and lower extremities. The posture varies with age because of the degenerative changes in the involved structures and the weakening of the muscles. The compensatory mechanisms underlying these changes have recently been evaluated, and the loss of lumbar lordosis results in spinal kyphosis, pelvic retroversion, hip extension, knee flexion, and ankle dorsiflexion. These mechanisms are referred to as the hip–spine and knee–spine syndromes. The spine, hip, and knee are anatomically connected, and the pain and discomfort of the lower back, hip, and knee frequently arise due to degenerative changes of these structures. Thus, these mechanisms are considered as the knee–hip–spine syndrome. Spinal fusion, total hip arthroplasty, and total knee arthroplasty are the surgical procedures for severe degeneration, and their clinical outcomes for the affected sites are promising. However, despite surgeries, other structures may degenerate and result in complications, such as proximal junctional kyphosis and hip dislocation, following spinal fusion. Therefore, it is necessary to evaluate each patient under specific conditions and to treat each section while considering associations between the target structure and entire body. The purpose of this article is to introduce postural maintenance, variations with age, and improvements with surgical interventions of spine, hip, and knee as the knee–hip–spine syndrome.
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institution Kabale University
issn 2090-3464
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publishDate 2019-01-01
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series Advances in Orthopedics
spelling doaj-art-9d4527905d484eb689d37fa0e454ccfd2025-02-03T07:23:47ZengWileyAdvances in Orthopedics2090-34642090-34722019-01-01201910.1155/2019/84849388484938Knee–Hip–Spine Syndrome: Improvement in Preoperative Abnormal Posture following Total Knee ArthroplastyYasushi Oshima0Nobuyoshi Watanabe1Norishige Iizawa2Tokifumi Majima3Mitsuhiro Kawata4Shinro Takai5Department of Orthopaedic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, JapanDepartment of Orthopaedic Surgery, Kyoto Kujo Hospital, 10 Karahashi Rajomoncho, Minami-ku, Kyoto 601-8453, JapanDepartment of Orthopaedic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, JapanDepartment of Orthopaedic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, JapanSchool of Health Sciences, Bukkyo University, 7 Higashitoganoo-cho, Nakagyo-ku, Kyoto 604-8418, JapanDepartment of Orthopaedic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, JapanAn ergonomic upright body posture is maintained by the alignment of the spine, pelvis, and lower extremities, and the muscle strength of body trunk and lower extremities. The posture varies with age because of the degenerative changes in the involved structures and the weakening of the muscles. The compensatory mechanisms underlying these changes have recently been evaluated, and the loss of lumbar lordosis results in spinal kyphosis, pelvic retroversion, hip extension, knee flexion, and ankle dorsiflexion. These mechanisms are referred to as the hip–spine and knee–spine syndromes. The spine, hip, and knee are anatomically connected, and the pain and discomfort of the lower back, hip, and knee frequently arise due to degenerative changes of these structures. Thus, these mechanisms are considered as the knee–hip–spine syndrome. Spinal fusion, total hip arthroplasty, and total knee arthroplasty are the surgical procedures for severe degeneration, and their clinical outcomes for the affected sites are promising. However, despite surgeries, other structures may degenerate and result in complications, such as proximal junctional kyphosis and hip dislocation, following spinal fusion. Therefore, it is necessary to evaluate each patient under specific conditions and to treat each section while considering associations between the target structure and entire body. The purpose of this article is to introduce postural maintenance, variations with age, and improvements with surgical interventions of spine, hip, and knee as the knee–hip–spine syndrome.http://dx.doi.org/10.1155/2019/8484938
spellingShingle Yasushi Oshima
Nobuyoshi Watanabe
Norishige Iizawa
Tokifumi Majima
Mitsuhiro Kawata
Shinro Takai
Knee–Hip–Spine Syndrome: Improvement in Preoperative Abnormal Posture following Total Knee Arthroplasty
Advances in Orthopedics
title Knee–Hip–Spine Syndrome: Improvement in Preoperative Abnormal Posture following Total Knee Arthroplasty
title_full Knee–Hip–Spine Syndrome: Improvement in Preoperative Abnormal Posture following Total Knee Arthroplasty
title_fullStr Knee–Hip–Spine Syndrome: Improvement in Preoperative Abnormal Posture following Total Knee Arthroplasty
title_full_unstemmed Knee–Hip–Spine Syndrome: Improvement in Preoperative Abnormal Posture following Total Knee Arthroplasty
title_short Knee–Hip–Spine Syndrome: Improvement in Preoperative Abnormal Posture following Total Knee Arthroplasty
title_sort knee hip spine syndrome improvement in preoperative abnormal posture following total knee arthroplasty
url http://dx.doi.org/10.1155/2019/8484938
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