Hôpital Maisonneuve-Rosemont, Université de Montréal, 5415 Boulevard de l'Assomption, Montréal, Québec, H1T 2M4, Canada; Laboratoire de Recherche en Imagerie et Orthopédie, École de Technologie Supérieure, Centre de recherche, Centre Hospitalier de l'Université de Montréal, Tour Viger, 900, rue St-Denis, Local R11.322, Montréal, Québec, H2X 0A9, Canada.
Hôpital Maisonneuve-Rosemont, Université de Montréal, 5415 Boulevard de l'Assomption, Montréal, Québec, H1T 2M4, Canada.
Gait Posture. 2019 Jul;72:62-68. doi: 10.1016/j.gaitpost.2019.05.025. Epub 2019 May 22.
Achieving a neutral static Hip-Knee-Ankle angle (sHKA) measured on radiographs has been considered a factor of success for total knee arthroplasty (TKA). However, recent studies have shown that sHKA seems to have no effect on TKA survivorship. sHKA is not representative of the dynamic loading occurring during gait, unlike the dynamic HKA (dHKA).
The primary objective was to see if the sHKA is predictive of the dynamic HKA (dHKA). A secondary objective was to document to what degree the dHKA changes during gait.
We analysed 3D knee kinematics during gait of a cohort of 90 healthy individuals with the KneeKG™ system. dHKA was calculated and compared with sHKA. Knees were considered "Stable" if the dHKA remained in valgus or varus for greater than 95% of the corresponding phase, and "Changer" otherwise. Patient characteristics of the Stable and Changer knees were compared to find associated factors.
Absolute variation of dHKA during gait was 10.9 ± 5.3° for the whole cohort. The variation was less for the varus knees (10.3 ± 4.8°), than for the valgus knees (12.8 ± 6.1°, p = 0.008). We found low to moderate correlations (r = 0.266 to 0.553, p < 0.001) between sHKA and dHKA values for varus knees and no significant correlation for valgus knees. Twenty two percent (36/165) of the knees were considered Changers. The proportion of knees that were Changers was 15% of the varus versus 39% of the valgus (p < 0.001).
Lower limb radiographic measures of coronal alignment have limited value for predicting dynamic measures of alignment during gait.
在放射影像上获得中立静态髋膝踝角（sHKA）被认为是全膝关节置换术（TKA）成功的一个因素。然而，最近的研究表明，sHKA 似乎对 TKA 的存活率没有影响。sHKA 与动态髋膝踝角（dHKA）不同，它不能代表步态时的动态加载。
主要目的是观察 sHKA 是否能预测动态髋膝踝角（dHKA）。次要目的是记录 dHKA 在步态中变化的程度。
我们使用 KneeKG™ 系统分析了 90 名健康个体步态的 3D 膝关节运动学。计算并比较了 dHKA 和 sHKA。如果 dHKA 在相应相位的 95%以上保持在外翻或内翻，膝关节则被认为是“稳定”的，否则为“变化”。比较稳定和变化的膝关节的患者特征，以找到相关因素。
整个队列在步态中的 dHKA 绝对变化为 10.9±5.3°。内翻膝关节的变化较小（10.3±4.8°），而外翻膝关节的变化较大（12.8±6.1°，p=0.008）。我们发现，对于内翻膝关节，sHKA 和 dHKA 值之间的相关性较低至中度（r=0.266 至 0.553，p<0.001），而对于外翻膝关节，没有显著相关性。22%（36/165）的膝关节被认为是变化者。变化者中内翻膝关节的比例为 15%，外翻膝关节的比例为 39%（p<0.001）。
下肢放射影像学冠状面排列的测量值对预测步态时的动态排列测量值的价值有限。
