Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), 4101, Bruderholz, Switzerland.
University of Basel, Basel, Switzerland.
Knee Surg Sports Traumatol Arthrosc. 2019 May;27(5):1359-1367. doi: 10.1007/s00167-019-05417-2. Epub 2019 Mar 8.
Coronal alignment of the knee is defined by the hip-knee-ankle angle (HKA), the femoral mechanical angle (FMA), the tibial mechanical angle (TMA), and the joint line convergence angle (JLCA). To date, there is still a lack of knowledge about the variability of native coronal knee alignment. The purpose of this paper is to present a systematic review of the current literature about the variability of coronal knee alignment (HKA, FMA, TMA, and JLCA) in non-osteoarthritic knees.
The electronic databases MEDLINE, EMBASE, and Google Scholar were searched from database inception to search date (November 1, 2018) and screened for relevant studies. The PRISMA guidelines were followed. Inclusion criteria were studies that reported the coronal alignment of the native, non-osteoarthritic knee.
A total of 15 studies met the inclusion criteria. Thirteen studies performed the measurements on weight-bearing long-leg standing radiographs (LLR), one study used MRI, and one study used the EOS imaging system. The mean HKA ranged from 176.7° ± 2.8° (male) to 180.7° (female). The mean FMA ranged from 92.08° ± 1.78° (female) to 97.2° ± 2.7° (female). The mean TMA ranged from 84.6° ± 2.5° (female) to 89.6° (female). The mean JLCA ranged from - 0.47° ± 0.98° (male) to - 1.9° ± 1.4° (female).
This systematic review provides a detailed overview about the variability of the coronal knee alignment in non-osteoarthritic knees. The broad variability of all coronal alignment parameters highlights the necessity for a more anatomic and individualized approach in knee arthroplasty. It also offers the fundament to understand the changes in osteoarthritic knees.
Systematic review, Level IV.
膝关节冠状面的对线由髋-膝-踝角（HKA）、股骨机械角（FMA）、胫骨机械角（TMA）和关节线会聚角（JLCA）来定义。迄今为止，对于正常膝关节冠状面对线的变异性，我们的认识仍然有限。本文的目的是对非骨关节炎膝关节冠状面（HKA、FMA、TMA 和 JLCA）对线变异性的现有文献进行系统回顾。
从数据库建立到 2018 年 11 月 1 日（搜索日期），在 MEDLINE、EMBASE 和 Google Scholar 电子数据库中进行检索，并筛选出相关研究。遵循 PRISMA 指南。纳入标准为报告正常、非骨关节炎膝关节冠状面对线的研究。
共有 15 项研究符合纳入标准。13 项研究在负重位下肢全长站立位 X 线片（LLR）上进行测量，1 项研究使用 MRI，1 项研究使用 EOS 成像系统。HKA 的平均值范围为 176.7°±2.8°（男性）至 180.7°（女性）。FMA 的平均值范围为 92.08°±1.78°（女性）至 97.2°±2.7°（女性）。TMA 的平均值范围为 84.6°±2.5°（女性）至 89.6°（女性）。JLCA 的平均值范围为-0.47°±0.98°（男性）至-1.9°±1.4°（女性）。
本系统回顾提供了非骨关节炎膝关节冠状面对线变异性的详细概述。所有冠状面对线参数的广泛变异性突出表明在膝关节置换术中需要更具解剖学和个体化的方法。它也为理解骨关节炎膝关节的变化提供了基础。
系统回顾，IV 级。
