Neutral alignment resulting from tibial vara and opposite femoral valgus is the main morphologic pattern in healthy middle-aged patients: an exploration of a 3D-CT database.
Adolescent
Adult
Aged
Aged, 80 and over
Ankle
/ anatomy & histology
Arthroplasty, Replacement, Knee
Child
Female
Femur
/ anatomy & histology
Hip
/ anatomy & histology
Humans
Imaging, Three-Dimensional
Knee Joint
/ anatomy & histology
Male
Middle Aged
Osteoarthritis, Knee
/ surgery
Osteotomy
Reference Values
Retrospective Studies
Tibia
/ anatomy & histology
Tomography, X-Ray Computed
Young Adult
Alignment
CT
HKA
HTO concepts
JLCA
Knee
LDFA
MPTA
Native
PPTA
Phenotypes
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
10
02
2020
accepted:
21
04
2020
pubmed:
7
5
2020
medline:
5
5
2021
entrez:
7
5
2020
Statut:
ppublish
Résumé
Given the goal of achieving optimal correction and alignment after knee arthroplasty or high tibial osteotomy, literature focusing on the inter-individual variability of the native knee, tibia and femur with regards to the coronal or sagittal alignment is lacking. The aim of this study was to analyse normal angular values in the healthy middle-aged population and determine differences of angular values according to inter-individual features. The first hypothesis was that common morphological patterns may be identified in the healthy middle-aged non-osteoarthritic population. The second hypothesis was that high inter-individual variability exists with regards to gender, ethnicity and alignment phenotype. A CT scan-based modelling and analysis system was used to examine the lower limb of 758 normal healthy patients (390 men, 368 women; mean age 58.5 ± 16.4 years) with available data concerning angular values and retrieved from the SOMA database. The hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), posterior distal femoral angle (PDFA), posterior proximal tibial angle (PPTA) and non weight-bearing joint line convergence angle (nwJLCA) were then measured for each patient. Results were analysed for the entire cohort and based on gender, ethnicity and phenotype. The mean HKA was 179.4° ± 2.6°, LDFA: 85.8° ± 2.0°, MPTA: 85.6° ± 2.4°, PDFA: 85.2° ± 1.5°, PPTA: 83.8° ± 2.9° and nwJLCA: 1.09° ± 0.9°. Gender was associated with higher LDFA and lower HKA for men. Ethnicity was associated with greater proximal tibial vara and distal femoral valgus for Asian patients. Patients with an overall global varus alignment had more tibia vara and less femoral valgus than patients with an overall valgus alignment. Even if significant differences were found based on subgroup analysis (gender, ethnicity or phenotype), this study demonstrated that neutral alignment is the main morphological pattern in the healthy middle-aged population. This neutrality is the result from tibia vara compensated by an ipsilateral femoral valgus. III, retrospective cohort study.
Identifiants
pubmed: 32372282
doi: 10.1007/s00167-020-06030-4
pii: 10.1007/s00167-020-06030-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
849-858Références
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