INTRODUCTION: The incidence of the combination of lumbar spondylolisthesis and knee or hip joint arthritis is unknown. Thus, we investigated the incidence of lumbar spondylolisthesis in patients with severe knee or hip arthritis.
METHODS: We studied 189 patients (165 women and 24 men) with knee osteoarthritis (OA) and 193 patients (174 women and 19 men) with hip OA. The mean age of those with knee OA and hip OA was 73 and 65 years old respectively. They underwent radiological examination of the lumbar spine and the knee or hip in a supine position before surgery, and underwent total knee or hip arthroplasty. Those under 50 years old and with rheumatoid arthritis (RA), trauma, and infection were excluded in this study. Spondylolisthesis greater than 3 mm in the lateral x‐ray view was considered as positive.
RESULTS: Fifty‐seven percent of the patients with knee OA were associated with spondylolisthesis. On the other hand, the incidence of spondylolisthesis was 20% in the patients with hip OA. There was a statistical significance of the incidence of spondylolisthesis between knee and hip OA. The relationship between OA grade and the incidence of spondylolisthesis was also investigated. The result showed that spondylolisthesis was found in 53% and 61% of knee‐OA patients with K‐L grade 3 and 4 respectively, and it was found in 18% and 21% of hip‐OA patients, respectively. There was no correlation between K‐L grade and the incidence of spondylolisthesis in both knee and hip OA.
DISCUSSION: The incidence of spondylolisthesis was high rate in patients who had severe osteoarthritis of knee. L4 nerve root pain arising from lumbar degeneration is relatively similar to knee joint pain due to osteoarthritis. Since the patient who complains the knee pain has a possibility of spondylolisthesis of the lumbar spine, careful examinations will need.