Tanaka Toshikazu, Takayama Koji, Hashimoto Shingo, Kanzaki Noriyuki, Hayashi Shinya, Kuroda Ryosuke, Matsumoto Tomoyuki
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.
Knee. 2017 Oct;24(5):1146-1152. doi: 10.1016/j.knee.2017.05.015. Epub 2017 Aug 8.
Several recent reports define the line from the centre of the femoral head to the lowest point of the calcaneus. The purpose of this study was to comparatively examine the usefulness of the hip-calcaneus (HC) line and hip-ankle (HA) line for the evaluation of lower-limb alignment in healthy individuals and in patients with osteoarthritis (OA).
Participants included 34 healthy individuals (mean age, 26.4years) and 34 patients with OA (mean age, 74.2years). Frontal radiographs of the entire lower limb were taken in single- and double-leg stances. For each group, the hip-knee-ankle (HKA) and hip-knee-calcaneus (HKC) angles were assessed and compared within and between stances. In addition, the HA line and HC line were assessed as the passing line in the knee, and were similarly compared.
Significant differences between the HKA and HKC angles, and between the HA line and HC line were observed in both groups during both stances. In addition, significant stance-related differences in the HKA and HKC angles, HA line, and HC line were found in the OA group, but not in the healthy group.
Our results suggest that the HC line of the lower limb differs from the HA line. Furthermore, single- and double-leg stances should also be considered, especially in patients with OA. These considerations may affect preoperative planning for high tibial osteotomies and TKA.
最近的几份报告定义了从股骨头中心到跟骨最低点的连线。本研究的目的是比较髋-跟骨（HC）线和髋-踝（HA）线在评估健康个体和骨关节炎（OA）患者下肢对线方面的有用性。
参与者包括34名健康个体（平均年龄26.4岁）和34名OA患者（平均年龄74.2岁）。在单腿和双腿站立姿势下拍摄整个下肢的正位X线片。对于每组，评估并比较站立姿势内和不同站立姿势间的髋-膝-踝（HKA）角和髋-膝-跟骨（HKC）角。此外，将HA线和HC线评估为膝关节的连线，并进行类似的比较。
在两种站立姿势下，两组的HKA角和HKC角之间以及HA线和HC线之间均观察到显著差异。此外，OA组的HKA角、HKC角、HA线和HC线存在与站立姿势相关的显著差异，而健康组未观察到。
我们的结果表明下肢的HC线与HA线不同。此外，尤其是OA患者，还应考虑单腿和双腿站立姿势。这些考虑因素可能会影响胫骨高位截骨术和全膝关节置换术的术前规划。
