Khalifa Ahmed A, Mullaji Arun B, Gendy Abanoub Nagaty, Ahmed Ahmed M, Bakr Hatem M, Khalifa Yaser E, Abdelaal Ahmed M
Orthopaedic Department, Qena Faculty of Medicine and University Hospital, South Valley University, Qena, Egypt.
Orthopaedic and Traumatology Department, Assiut University Hospital, Assiut, Egypt.
Eur J Orthop Surg Traumatol. 2021 Aug;31(6):1199-1205. doi: 10.1007/s00590-020-02853-6. Epub 2021 Jan 9.
Patients with varus and fixed flexion deformity (FFD) undergoing TKA may have a significant leg length change (LLC) after surgery. We aimed to determine the correlation between changes in HKA or FFD and leg length in patients undergoing TKA, the combined effect of coronal and sagittal plane deformity correction on LLC, and the possibility of estimating LLC mathematically.
This was a prospective radiographic evaluation of 242 knees, which had undergone primary unilateral TKA for advanced OA with varus and FFD. Full-length standing calibrated anteroposterior radiographs were used to measure the hip-knee-ankle axis (HKA) and functional leg length after adjusting for magnification. Clinical evaluation of FFD was done using a handheld goniometer.
224 knees (92.6%) showed increased limb length after TKA averaging 10.7 mm (SD 9.5 mm, P = .000). There was a significant correlation between the change in HKA and FFD from preoperatively to postoperatively with the amount of LLC (ρ 0.326 and 0.346, respectively, P = .000). FFD improvement from preoperatively to postoperatively was 8.1° to 1° (P = .000), respectively. A linear relationship was established between LLC and changes in HKA and FFD, where 10° improvement in HKA would result in an LLC of nearly 4 mm, and 10° improvement in FFD would result in a LLC of nearly 8 mm.
LLC may be substantial after correcting varus and FFD with unilateral TKA, it correlates with the change in HKA and FFD and can be mathematically estimated. CLINICAL TRIALS .
NCT03502382.
接受全膝关节置换术（TKA）的内翻和固定屈曲畸形（FFD）患者术后可能会出现明显的腿长变化（LLC）。我们旨在确定接受TKA患者的髋膝踝角（HKA）或FFD变化与腿长之间的相关性、冠状面和矢状面畸形矫正对LLC的联合影响以及通过数学方法估算LLC的可能性。
这是一项对242例膝关节进行的前瞻性影像学评估，这些膝关节因晚期内翻和FFD的骨关节炎接受了初次单侧TKA。使用全长站立校准前后位X线片测量髋膝踝轴（HKA）并在调整放大率后测量功能腿长。使用手持测角仪对FFD进行临床评估。
224例膝关节（92.6%）TKA术后肢体长度增加，平均增加10.7毫米（标准差9.5毫米，P = 0.000）。术前至术后HKA和FFD的变化与LLC的量之间存在显著相关性（分别为ρ 0.326和0.346，P = 0.000）。术前至术后FFD改善分别为8.1°至1°（P = 0.000）。在LLC与HKA和FFD的变化之间建立了线性关系，其中HKA改善10°将导致LLC接近4毫米，FFD改善10°将导致LLC接近8毫米。
单侧TKA矫正内翻和FFD后LLC可能很大，它与HKA和FFD的变化相关，并且可以通过数学方法估算。临床试验。
NCT03502382。
