Zheng Xin, Wang Yang-Yu-Fan, Jin Wang-Yi, Huang Chao-Ran, Yan Zi-Wen, Peng Da-Lin, Zhou Shen, Guo Kai-Jin, Pan Sheng
Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Front Surg. 2023 Mar 1;10:964160. doi: 10.3389/fsurg.2023.964160. eCollection 2023.
To determine the side-to-side difference in intraindividual rotation alignment of patients with bilateral varus-type knee osteoarthritis (OA) and compare it with control subjects.
This retrospective study enrolled 60 patients with bilateral varus-type knee OA and 50 control subjects. All cases underwent bilateral lower limb CT angiography. Bilateral femoral and tibial rotation alignment were measured, and the overall lower limb rotation was calculated by two different methods. Method 1 was calculated by subtracting angle of the femoral torsion from the tibial torsion and method 2 was determined by relative rotation of the femoral neck angle to bimalleolar angle. The intraindividual variance and differences between the two groups were analyzed.
Both OA and control samples showed significant differences between right and left for all measurements. Femoral torsion for control group was 10.4 ± 5.5°, tibial torsion was -22.1 ± 6.1°, and overall leg rotation by method 1 was -15.6 ± 7.2° and method 2 was -11.7 ± 8.2°. Femoral torsion, tibial torsion, method 1, and method 2 in the patients with OA were 8.2 ± 6.3°, -18.6 ± 4.1°, -14.9 ± 7.9°, and -10.4 ± 7.6°, respectively. Patients with OA showed a more pronounced retroversion in the femur (= 0.008) and more internal rotation in the tibia (<0.001). No statistical significance of both methods was found between the two groups. Patients with OA had a greater median side-to-side absolute difference in all measurements, though the differences of both two methods of overall lower limb rotation were not statistically significant.
The discrepancy of side-to-side differences of bilateral lower limb rotation ought to be noticed with caution in diagnosing and treating rotational deformities of the lower limb, especially for patients with bilateral knee OA.
确定双侧内翻型膝骨关节炎（OA）患者个体内旋转对线的左右差异，并与对照组进行比较。
这项回顾性研究纳入了60例双侧内翻型膝OA患者和50例对照者。所有病例均接受双侧下肢CT血管造影。测量双侧股骨和胫骨的旋转对线，并通过两种不同方法计算下肢整体旋转。方法1通过从胫骨扭转角度中减去股骨扭转角度来计算，方法2通过股骨颈角度与双踝角度的相对旋转来确定。分析个体内差异和两组之间的差异。
OA组和对照组在所有测量中左右侧均显示出显著差异。对照组的股骨扭转角度为10.4±5.5°，胫骨扭转角度为-22.1±6.1°，方法1计算的下肢整体旋转角度为-15.6±7.2°，方法2为-11.7±8.2°。OA患者的股骨扭转、胫骨扭转、方法1和方法2分别为8.2±6.3°、-18.6±4.1°、-14.9±7.9°和-10.4±7.6°。OA患者的股骨后倾更明显（=0.008），胫骨内旋更多（<0.001）。两组之间两种方法均无统计学意义。OA患者在所有测量中的左右侧绝对差异中位数更大，尽管两种下肢整体旋转方法的差异无统计学意义。
在诊断和治疗下肢旋转畸形时，尤其是双侧膝OA患者，应谨慎注意双侧下肢旋转左右差异的不一致性。
