Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Seoul Hospital, Hanyang University Medical Center, Seoul, Korea.
Knee Surg Sports Traumatol Arthrosc. 2021 Apr;29(4):1098-1105. doi: 10.1007/s00167-020-06100-7. Epub 2020 Jun 15.
To evaluate the rotational profile of the lower extremity using computed tomography (CT) in accordance with the degree of varus deformity in medial condyle-affected knee joint osteoarthritis (OA).
This retrospective study included 1036 patients (872 lower extremities) with end-stage knee OA. The coronal alignment of the lower extremity was measured using standing anteroposterior radiography. The CT parameters of femoral anteversion and tibial torsion were assessed in relation to the knee joint. The axes were the femoral neck axis; the distal femoral axis, which was composed of the anterior trochlear axis, the clinical transepicondylar axis, and the posterior condylar axis; the axis of the proximal tibial condyles; and the bimalleolar axis.
There was a tendency for increased external rotation of the knee joint parameters in relation to the hip and ankle joints as varus deformity of the lower extremity increased. The relative external rotational deformity of the knee joint in relation to the hip joint had a positive value with a good correlation. The relative external rotational deformity of the knee joint in relation to the ankle joint also demonstrated a positive value with a good correlation.
The distal femur and proximal tibia (knee joint) tended to rotate externally in relation to the hip and ankle joint, respectively, as the degree of varus deformity increased. This study identified the relationship between lower extremity varus deformity and rotational deformity of knee joints with OA.
III.
利用计算机断层扫描（CT）评估内侧髁受累膝关节骨关节炎（OA）的下肢旋转形态与内翻畸形程度的关系。
本回顾性研究纳入了 1036 例（872 条下肢）终末期膝 OA 患者。采用站立前后位 X 线片测量下肢冠状面对线。评估 CT 股前倾角和胫骨扭转参数与膝关节的关系。参考轴包括股骨颈轴；由前滑车轴、临床髁间轴和后髁轴组成的远端股骨轴；胫骨近端关节面轴；以及内外踝轴。
随着下肢内翻畸形程度的增加，膝关节参数相对于髋关节和踝关节有增加外旋的趋势。膝关节相对于髋关节的相对外旋畸形呈正相关，且相关性良好。膝关节相对于踝关节的相对外旋畸形也呈正相关，且相关性良好。
随着内翻畸形程度的增加，远端股骨和近端胫骨（膝关节）相对于髋关节和踝关节分别有外旋的趋势。本研究确定了下肢内翻畸形与 OA 膝关节旋转畸形之间的关系。
III 级。
