CORR Insights^®: Coexisting Lumbar Spondylosis in Patients Undergoing TKA: How Common and How Serious?

Excerpt

The current study by Chang and colleagues is of major interest to orthopaedic surgeons. To date, there is essentially no information specifically evaluating the effect of a symptomatic spinal disorder on the results of knee arthroplasty. The effects of knee arthroplasty on the natural history of a symptomatic spinal disorder also have been largely ignored. Joint degeneration is rarely isolated, and surgeons can expect patients with advanced knee arthritis to have coexisting degenerative disease elsewhere, including the spine. Identification and understanding of the relationships of these coexisting problems are potentially important. In this study, the authors evaluated the relationship between lumbar spinal disorders and knee osteoarthritis. It is important to note that the authors used data from a knee-specific registry. As a consequence, there are real limitations regarding the spine data. Screening criteria primarily were based on radiographs. It is well known that there is essentially no correlation between radiographs and clinical disorders of the spine. There was no advanced imaging to diagnose specific disorders, nor any mention of deformities affecting sagittal or coronal balance. Lastly, the categories assigned to the spine were not really disorders at all, merely descriptors of pain based on the visual analog scale. …