Gao Fuqiang, Ma Jinhui, Sun Wei, Guo Wanshou, Li Zirong, Wang Weiguo
Center for Osteonecrosis and Joint Preserving & Reconstruction, Department of Orthopaedic Surgery, China-Japan Friendship Hospital, 2 Yinghuadong Road, Chaoyang District, Beijing 100029 China.
Peking University China-Japan Friendship School of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing 100029 China.
Eur J Radiol. 2016 Jan;85(1):228-232. doi: 10.1016/j.ejrad.2015.11.021. Epub 2015 Nov 18.
The lower limb misalignment as calculated by radiography has an evident effect on the development and progression of knee osteoarthritis (OA). However, whether the knee malalignment has an influence on ankle alignment is unknown. The purpose of this study was to discuss the correlation between knee and ankle alignment in varus and valgus gonarthrosis.
This is a retrospective study of 149 patients with symptomatic varus and valgus knee OA who intend to take total knee arthroplasty (TKA) between January and October 2013. A protocol for the measurement of knee-ankle alignment and angles on full-length standing anteroposterior radiographs of the lower extremity was outlined in detail with step-by-step instructions. Two observers measured the angles chosen. The Pearson's correlation tests were used for the statistical analysis.
Pearson's correlation test results for unilateral varus or valgus gonarthrosis showed that the varus or valgus deformity of the knee can influence the tilt angle and tibiotalar angle of the ankle in operative side signficantly(p<0.05), and the tilt angle of the ankle can also be affected in nonoperative side (p<0.05). Moreover, the tilt angle of the bilateral ankle can be simultaneously affected in bilateral varus gonarthrosis (p<0.05).
These findings suggest that the varus and valgus deformity of the knee can induce the tilt of the ankle and influence the ankle alignment, which may further accelerate the degeneration of the ankle. Moreover, the knee alignment in the nonoperative side can also result in the change of ankle alignment at the same time.
通过影像学计算得出的下肢力线不齐对膝关节骨关节炎（OA）的发展和进程有显著影响。然而，膝关节力线不齐是否会影响踝关节力线尚不清楚。本研究的目的是探讨内翻和外翻膝关节炎中膝关节与踝关节力线之间的相关性。
这是一项对149例有症状的内翻和外翻膝关节OA患者的回顾性研究，这些患者于2013年1月至10月期间打算接受全膝关节置换术（TKA）。详细概述了一种用于测量下肢全长站立前后位X线片上膝关节-踝关节力线和角度的方案，并给出了逐步说明。两名观察者测量了选定的角度。采用Pearson相关性检验进行统计分析。
单侧内翻或外翻膝关节炎的Pearson相关性检验结果显示，膝关节的内翻或外翻畸形可显著影响患侧踝关节的倾斜角和胫距角（p<0.05），非患侧踝关节的倾斜角也会受到影响（p<0.05）。此外，双侧内翻膝关节炎时双侧踝关节的倾斜角可同时受到影响（p<0.05）。
这些发现表明，膝关节的内翻和外翻畸形可导致踝关节倾斜并影响踝关节力线，这可能会进一步加速踝关节的退变。此外，非手术侧的膝关节力线同时也可导致踝关节力线的改变。
