Huan Wang, Mochizuki Tomoharu, Tanifuji Osamu, Kawashima Hiroyuki
Division of Orthopedic Surgery, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori Chuo-ku, Niigata City, 951-8510, Japan.
Department of Orthopedic Surgery, The First Affiliated Hospital, Harbin Medical University, Harbin, China.
Knee Surg Sports Traumatol Arthrosc. 2023 Apr;31(4):1451-1461. doi: 10.1007/s00167-022-07248-0. Epub 2022 Nov 30.
New concept of functional knee phenotypes in Caucasians demonstrated the variability of coronal alignment in knee osteoarthritis (OA), but it remains unclear in Japanese. This study aims to analyze the knee phenotype in advanced varus knee OA for Japanese. In addition, the ethnical difference is discussed.
This study analyzed 879 knees involving 186 males (74 years) and 693 females (74 years). The knee phenotypes were assessed by the definition in Hirschmann's group. The hip-knee-ankle angle (HKA), femoral mechanical angle (FMA) and tibial mechanical angle (TMA) were assessed in CT data according to the coordinate system. The neutral angle was 180° in HKA, 93° in FMA and 87° in TMA. The smaller angle means larger varus angles.
The average angle (males, females) of the HKA (170.9 ± 4.3°, 169.4 ± 5.0°), FMA (91.5 ± 2.7°, 90.6 ± 3.0°), and TMA (82.4 ± 3.6°, 82.7 ± 3.7°) demonstrated varus angles with the sex difference (HKA, p < 0.001; FMA, p = 0.001). The phenotypes were 73 types in males and 150 types in females with a mild correlation between the HKA and the FMA or TMA. In 61.3% of males and 52.2% of females, the TMA was greater than the FMA, while the FMA was greater in 16.7% of males and 23.1% of females.
There were many functional knee phenotypes with sex differences for advanced varus knee OA in Japanese, showing ethnical differences of larger varus angles compared to those for Caucasians in the previous report.
IV.
白种人功能性膝关节表型的新概念表明了膝关节骨关节炎（OA）中冠状面排列的变异性，但在日本人中仍不清楚。本研究旨在分析日本晚期内翻膝关节OA的膝关节表型。此外，还讨论了种族差异。
本研究分析了879个膝关节，其中包括186名男性（74岁）和693名女性（74岁）。膝关节表型根据赫希曼小组的定义进行评估。根据坐标系在CT数据中评估髋-膝-踝角（HKA）、股骨机械角（FMA）和胫骨机械角（TMA）。HKA的中立角为180°，FMA为93°，TMA为87°。角度越小，内翻角度越大。
HKA（男性，170.9±4.3°，女性，169.4±5.0°）、FMA（男性，91.5±2.7°，女性，90.6±3.0°）和TMA（男性，82.4±3.6°，女性，82.7±3.7°）的平均角度显示出内翻角度存在性别差异（HKA，p<0.001；FMA，p=0.001）。男性的表型有73种，女性有150种，HKA与FMA或TMA之间存在轻度相关性。在61.3%的男性和52.2%的女性中，TMA大于FMA，而在16.7%的男性和23.1%的女性中，FMA更大。
日本晚期内翻膝关节OA存在许多具有性别差异的功能性膝关节表型，与之前报道的白种人相比，内翻角度更大，存在种族差异。
IV级。
