Sappey-Marinier Elliot, Batailler Cécile, Swan John, Malatray Matthieu, Cheze Laurence, Servien Elvire, Lustig Sébastien
Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital de la Croix Rousse, 103 grande rue, 69004, Lyon, France.
Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR LBMC UMR-T9406, 69622, Lyon, France.
Knee Surg Sports Traumatol Arthrosc. 2022 Feb;30(2):428-436. doi: 10.1007/s00167-020-06083-5. Epub 2020 Jun 1.
Many surgeons are performing total knee arthroplasty (TKA) with an aim to reproducing native anatomical coronal alignment. Yet, it remains unclear if primary osteoarthritic and non-osteoarthritic populations have similar knee coronal alignment. This study aims to describe and compare the distribution of femoral and tibial coronal alignment in a large primary osteoarthritic cohort and a young non-osteoarthritic cohort.
This is a retrospective analysis of a monocentric prospectively gathered data, from 1990 to 2019, of 2859 consecutive primary osteoarthritic knees in 2279 patients. Patients underwent standardized long-leg radiographs. Femoral mechanical angle (FMA) and tibial mechanical angle (TMA) were digitally measured using software. Femoral, tibial and knee phenotypes were analyzed, and descriptive data were reported. Data were compared to a young non-osteoarthritic population previously described.
In osteoarthritic knees, the mean FMA was 91° ± 2.9° (range 86°-100°) and the mean TMA was 87° ± 3.1° (range 80°-94°). No significant difference was observed for FMA and TMA between genders. The most common femoral and tibial phenotypes were varus (38.7%) and neutral (37.1%). The most frequent knee phenotype was a varus femoral phenotype with a neutral tibial phenotype (15.5%), which is different to the non-osteoarthritic population.
This study showed the wide distribution of knee phenotypes in a large osteoarthritic cohort. There was more varus distribution of the femoral coronal alignment compared to a non-osteoarthritic population, suggesting consideration and potential adaptation of the realignment strategy of the femoral component during TKA.
III.
许多外科医生进行全膝关节置换术（TKA）的目的是恢复膝关节的自然解剖冠状位对线。然而，原发性骨关节炎患者和非骨关节炎患者的膝关节冠状位对线是否相似仍不清楚。本研究旨在描述和比较大型原发性骨关节炎队列和年轻非骨关节炎队列中股骨和胫骨冠状位对线的分布情况。
这是一项对单中心前瞻性收集数据的回顾性分析，数据来自1990年至2019年的2279例患者的2859个连续原发性骨关节炎膝关节。患者接受标准化的长腿X线片检查。使用软件对股骨机械角（FMA）和胫骨机械角（TMA）进行数字测量。分析股骨、胫骨和膝关节的表型，并报告描述性数据。将数据与先前描述的年轻非骨关节炎人群进行比较。
在骨关节炎膝关节中，平均FMA为91°±2.9°（范围86°-100°），平均TMA为87°±3.1°（范围80°-94°）。FMA和TMA在性别之间未观察到显著差异。最常见的股骨和胫骨表型是内翻（38.7%）和中立位（37.1%）。最常见的膝关节表型是股骨内翻表型伴胫骨中立位表型（15.5%），这与非骨关节炎人群不同。
本研究显示了大型骨关节炎队列中膝关节表型的广泛分布。与非骨关节炎人群相比，股骨冠状位对线的内翻分布更多，这表明在TKA期间应考虑并可能调整股骨组件的重新对线策略。
III级。
