Clinical relationships between lower back pain and knee osteoarthritis

Knee osteoarthritis (OA), also known as degenerative joint disease of the knee, is typically the result of wear and tear and progressive loss of articular cartilage.

Osteoarthritis (OA) and lower back pain (LBP) are the most common health problems that lead to pain and disability worldwide. OA is a major form of arthritis causing pain and disability.

Aetiology 

1. Alignment of lumbar-pelvic and lower extremities - The lumbar spine serves as the primary source of compensation, while hip flexion and pelvic anteversion increase for further compensation.
2. Greater pelvic anterior tilt: study showed greater pelvic anterior tilt (44.68°) angle was found in the patients with knee OA of both the LBP and non-LBP groups compared to healthy people.
3. Pelvic retroversion causing hip external rotation and varus knee deformity - Pelvic retroversion is related to standing position. Varus knee alignment increases the medial tibiofemoral load and is associated with knee osteoarthritis. Thus, sagittal lumbo-pelvic malalignment, especially pelvic retroversion, could lead to the progression of OA

References
 

• Amarasinghe, P., Wadugodapitiya, S., & Weerasekara, I. (2023). Biomechanical and clinical relationships between lower back pain and knee osteoarthritis: a systematic review. Systematic reviews, 12(1), 28. https://doi.org/10.1186/s13643-022-02164-3
• Suri P, Morgenroth DC, Kwoh CK, Bean JF, Kalichman L, Hunter DJ. Low back pain and other musculoskeletal pain comorbidities in individuals with symptomatic osteoarthritis of the knee: data from the osteoarthritis initiative. Arthritis Care Res. 2010;62:1715–1723. doi: 10.1002/acr.20324.
• Yasuda T, Togawa D, Hasegawa T, Yamato Y, Kobayashi S, Yoshida G, et al. Relationship between knee osteoarthritis and spinopelvic sagittal alignment in volunteers over 50 years of age. Asian Spine J. 2020;14:495–501. doi: 10.31616/asj.2018.0266.
   

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