iULS-University Institute for Locomotion and Sports, Pasteur 2 Hospital, University Côte d'Azur, Nice, France.
Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopedics and Traumatology, Marseille, France.
Knee Surg Sports Traumatol Arthrosc. 2021 Mar;29(3):849-858. doi: 10.1007/s00167-020-06030-4. Epub 2020 May 5.
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.
膝关节置换或胫骨高位截骨术后追求最佳矫正和对线，而目前针对膝关节、胫骨和股骨的自然状态下冠状面或矢状面的个体间差异的文献却相对较少。本研究旨在分析健康中年人群的正常角度值，并确定角度值在个体特征方面的差异。第一个假设是，在健康的中年非骨关节炎人群中可能会发现常见的形态模式。第二个假设是，性别、种族和对线表型之间存在高度的个体间变异性。
使用基于 CT 扫描的建模和分析系统检查了来自 SOMA 数据库的 758 名正常健康患者（390 名男性，368 名女性；平均年龄 58.5±16.4 岁）的下肢，这些患者的角度值数据可用。然后测量每位患者的髋膝踝角（HKA）、外侧远端股骨角（LDFA）、内侧近端胫骨角（MPTA）、后侧远端股骨角（PDFA）、后侧近端胫骨角（PPTA）和非负重关节线会聚角（nwJLCA）。结果根据性别、种族和表型进行了分析。
平均 HKA 为 179.4°±2.6°，LDFA：85.8°±2.0°，MPTA：85.6°±2.4°，PDFA：85.2°±1.5°，PPTA：83.8°±2.9°和 nwJLCA：1.09°±0.9°。男性的 LDFA 较高，HKA 较低。与亚洲患者相比，种族与更大的胫骨近端内翻和股骨远端外翻有关。与整体外翻对线的患者相比，整体全局内翻对线的患者胫骨内翻更多，股骨外翻更少。
即使基于亚组分析（性别、种族或表型）发现了显著差异，但本研究表明，中立对线是健康中年人群的主要形态模式。这种中立性是胫骨内翻由同侧股骨外翻补偿的结果。
III，回顾性队列研究。
