Asymmetric transepicondylar axis between varus and valgus osteoarthritic knees in windswept deformity can be predicted by hip–knee–ankle angle difference

2021 ◽  
Author(s):  
Yun Seong Choi ◽  
Tae Woo Kim ◽  
Seung Cheol Song ◽  
Sang Yoon Kim ◽  
Moon Jong Chang ◽  
...  
Keyword(s):  
Transepicondylar Axis ◽  
Ankle Angle ◽  
Angle Difference ◽  
Hip Knee Ankle Angle

Computer Animation of Gait

1978 ◽  
Vol 7 (2) ◽  
pp. 111-113 ◽  
Author(s):  
D. R. Broome
Keyword(s):  
Computer Graphics ◽  
Computer Animation ◽  
Fourier Coefficients ◽  
Two Dimensional ◽  
Ankle Angle ◽  
Hip Knee Ankle Angle ◽  
Displacement Information ◽  
Leg Movements

A program has been written which enables two dimensional visualization of leg movements on a computer graphics display. Hip, knee, ankle angle, and pelvic displacement information can be input and processed to obtain Fourier coefficients characterizing these motions. The thigh, shank and foot are then displayed at, for example, two hundred points within each walking cycle, at natural speed or as slowly as desired.

scholarly journals Predicting the mechanical hip–knee–ankle angle accurately from standard knee radiographs: a cross-validation experiment in 100 patients

2020 ◽  
pp. 1-6
Author(s):  
Willem Paul Gielis ◽  
Hassan Rayegan ◽  
Vahid Arbabi ◽  
Seyed Y Ahmadi Brooghani ◽  
Claudia Lindner ◽  
...  
Keyword(s):  
Cross Validation ◽  
Validation Experiment ◽  
Ankle Angle ◽  
Hip Knee Ankle Angle

scholarly journals Outcomes and component-positioning in total knee arthroplasty may be comparable between supervised trained surgeons and their supervisor

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Kazumi Goto ◽  
Yozo Katsuragawa ◽  
Yoshinari Miyamoto
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Operative Time ◽  
Case Series ◽  
Level Of Evidence ◽  
Ankle Angle ◽  
Total Knee ◽  
The Mean ◽  
Hip Knee Ankle Angle

Abstract Purpose There are concerns that malalignment in total knee arthroplasty (TKA) occurs with less experienced surgeons. This study investigates the influence of surgical experience on TKA outcomes. Materials and methods Nineteen patients (38 knees) who underwent bilateral TKA between 2011 and 2015 were included. A supervisor performed knee replacements associated with lower Knee Society Scores (KSS); trainee surgeons operated on the other knee. Knees were categorized into two groups: operations by the supervisor (group S) versus operations by trainee surgeons (group T). Range of motion (ROM), KSS, operative time, hip–knee–ankle angle, and femoral and tibial component angle were evaluated. Results The mean operative time was 92.5 min in group S and 124.2 min in group T (p < 0.01). The mean postoperative maximal flexion was 113.2° in group S and 114.2° in group T (not significant). The mean postoperative KSS was 92.9 in group S and 93.9 in group T (not significant). No significant differences between groups in terms of proportion of inliers for the hip–knee–ankle angle, femoral component angle, or tibial component angle were observed. Conclusions Although operative time was significantly longer for trainee surgeons versus the supervisor, no significant differences in ROM, KSS, or component positioning between supervisor and trainee surgeons were observed. Level of evidence IV (retrospective case series design).

Association of Preoperative Tibial Varus Deformity With Joint Line Orientation and Clinical Outcome After Open-Wedge High Tibial Osteotomy for Medial Compartment Osteoarthritis: A Propensity Score–Matched Analysis

2021 ◽  
pp. 036354652110441
Author(s):  
Jun-Gu Park ◽  
Seung-Beom Han ◽  
Ki-Mo Jang
Keyword(s):  
Varus Deformity ◽  
Important Change ◽  
Joint Line ◽  
Ankle Angle ◽  
Joint Line Obliquity ◽  
Group 2 ◽  
Hip Knee Ankle Angle ◽  
Minimally Important Change ◽  
Group 1

Background: The correction of lower limb deformity should be performed at the site of deformity to maintain knee joint orientation. However, the effectiveness of open-wedge high tibial osteotomy (OWHTO) for treatment of medial osteoarthritis in varus malalignment without definite tibial varus deformity has not been confirmed. Purpose/Hypothesis: This study aimed to compare the clinical and radiologic outcomes after OWHTO in patients without tibial varus deformity versus patients with tibial varus deformity after matching for confounding factors. We hypothesized that these outcomes would be inferior in patients without tibial varus deformity. Study Design: Cohort study; Level of evidence, 3. Methods: The outcomes of 133 OWHTO operations for medial osteoarthritis in 107 patients were retrospectively reviewed after follow-up for >2 years. The patients were divided into group 1 (tibia with varus deformity, preoperative medial proximal tibial angle [MPTA] <85°) and group 2 (tibia without varus deformity, preoperative MPTA ≥85°). The confounding factors, including patient characteristics, preoperative limb alignment, degree of osteoarthritis, and correction angle, were matched using propensity score matching. The radiologic parameters, including MPTA and joint line obliquity, were evaluated preoperatively, between 6 and 12 months postoperatively, and at the last follow-up. The radiologic outcomes were assessed using the medial joint space width and mechanical hip-knee-ankle angle. The clinical outcomes were evaluated by the Hospital for Special Surgery knee score, Knee Society Score (KSS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. The clinical and radiologic outcomes were compared between the groups. The proportions of patients achieving improvement in the clinical outcome beyond the minimal clinically important difference (MCID) or minimally important change were compared between the groups. Results: After propensity score matching, 32 patients were selected for each group. The mechanical hip-knee-ankle angle was corrected without significant difference from a mean ± SD varus angle of 8.0°± 3.3° to valgus angle of −3.2°± 2.5° in group 1 and from varus 8.0°± 3.6° to valgus −3.9°± 1.7° in group 2. The preoperative joint line obliquity was greater in group 2 as compared with group 1 (2.2°± 2.2° vs −0.4°± 1.8°, P < .001). With a similar 10° correction angle, the postoperative MPTA and joint line obliquity were 96.6°± 2.5° and 5.3°± 2.3°, respectively, in group 2, which were greater than 94.0°± 2.6° and 3.5°± 1.8°, respectively, in group 1 (both P < .001). The changes in joint space width and mechanical hip-knee-ankle angle were not significantly different between the groups over the follow-up period. At the last follow-up, the postoperative KSS objective score and WOMAC pain score in terms of symptom improvement were not significantly different between groups ( P = .092 and .068). However, the postoperative KSS and WOMAC functional scores were significantly worse in group 2 than in group 1 (77.3 ± 14.1 vs 84.4 ± 11.6, P = .044; 10.3 ± 9.2 vs 5.6 ± 7.2, P = .001). In group 1, 96.9% and 100% of patients showed improvements of >10 points in the KSS functional score and 15 points in the WOMAC functional score based on MCID or minimally important change. Meanwhile, 65.6% and 81.3% of patients in group 2, which were significantly lower than those of group 1, were improved beyond the MCID or minimally important change ( P = .001 and .024, respectively). Conclusion: In varus malalignment, the knee joint line was more oblique in patients without tibial varus deformity after OWHTO pre- and postoperatively. The clinical outcomes in terms of functional scores were inferior in patients without tibial varus deformity. However, the radiologic outcomes and symptomatic improvement after OWHTO were comparable regardless of the preoperative tibial varus deformity on midterm follow-up.

scholarly journals Knee thrust prevalence and normative hip-knee-ankle angle deviation values among healthy individuals across the lifespan

2018 ◽  
Vol 26 (10) ◽  
pp. 1326-1332 ◽  
Author(s):  
Y.Y. Palad ◽  
A.M. Leaver ◽  
M.J. McKay ◽  
J.N. Baldwin ◽  
F.R.M. Lunar ◽  
...  
Keyword(s):  
Healthy Individuals ◽  
Angle Deviation ◽  
Ankle Angle ◽  
Hip Knee Ankle Angle

scholarly journals No difference of survival between cruciate retaining and substitution designs in high flexion total knee arthroplasty

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gun-Woo Kim ◽  
Quan He Jin ◽  
Jun-Hyuk Lim ◽  
Eun-Kyoo Song ◽  
Jong-Keun Seon
Keyword(s):  
Survival Rate ◽  
Survival Rates ◽  
Cruciate Retaining ◽  
High Flexion ◽  
Significant Difference ◽  
Ankle Angle ◽  
Total Knee ◽  
The Mean ◽  
Hip Knee Ankle Angle

AbstractThe aim of this study was to compare the long-term implant survival and outcomes in patients with high-flexion cruciate-retaining (CR) or high-flexion posterior cruciate-substituting (PS) knee implants. A total of 253 knees (CR group: 159 vs. PS group: 94) were available for examination over a mean follow-up of 10 years. Clinical outcomes were assessed including the Hospital for Special Surgery score, Knee Society score and Western Ontario and McMaster Universities Osteoarthritis Index score at the final follow-up. Radiologic measurements were also assessed including the hip-knee-ankle angle and radiolucent lines according to the KSS system at the final follow-up. The survival rate was analyzed using the Kaplan–Meier method. At the final follow-up, the mean total HSS scores were similar between the two groups (p = 0.970). The mean hip-knee-ankle angle at the final follow-up was similar between groups (p = 0.601). The 10- and 15-year survival rates were 95.4% and 93.3% in the CR group and 92.7% and 90.9% in the PS group, respectively, with no significant difference. Similar clinical and radiographic outcomes could be achieved with both the high-flexion CR and high-flexion PS total knee designs without a difference in survival rate after a 10-year follow-up.

scholarly journals The Influence of Adipose-derived Stromal Vascular Fraction Cells on the Treatment of Knee Osteoarthritis

2020 ◽  
Author(s):  
Masanori Tsubosaka ◽  
Tomoyuki Matsumoto ◽  
Satoshi Sobajima ◽  
Takehiko Matsushita ◽  
Hideki Iwaguro ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
T2 Mapping ◽  
Stromal Vascular Fraction ◽  
Short Term ◽  
Cell Injection ◽  
Knee Oa ◽  
Ankle Angle ◽  
The Mean ◽  
Hip Knee Ankle Angle ◽  
Better Than

Abstract Background Adipose-derived stromal vascular fraction (SVF) cells are a mixed cell population that includes cells with multilineage potential, similar to bone marrow-derived mesenchymal stem cells. Our purpose is to investigate the influence of SVF cells in patients with knee osteoarthritis (OA) and the short-term treatment effects. Methods Fifty-seven patients were enrolled and treated with intra-articular injection of 5.0×10 7 SVF cells into the knee joint between September 2017 and March 2018. All patients were followed up for 12 months or longer. Mean age at treatment and follow-up period were 69.4±6.9 years and 13.7±2.0 months, respectively. The mean preoperative hip-knee-ankle angle was 6.7±3.6°. SVF cells were prepared using the Celution®800/CRS system from the patients’ abdominal or breech subcutaneous fat. The mean SVF cell viability was 90.6±2.7%. Clinical evaluations were performed for range of motion, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and the Knee injury and Osteoarthritis Outcome Score (KOOS). Imaging evaluations, which included the hip-knee-ankle angle assessed via radiography, and T2 mapping value using a 3.0-T magnetic resonance imaging unit were also assessed. Both clinical and imaging evaluations were performed preoperatively, 1, 3, 6, and 12 months postoperatively, and compared among all timepoints (p<0.05). Results Knee extension angle at 6 and 12 months postoperatively was significantly better than the preoperative angle. Total WOMAC, VAS, and KOOS scores at 1, 3, 6 and 12 months postoperatively were significantly better than preoperative scores. There was no significant difference in hip-knee-ankle angle among the five time periods. T2 mapping values of lateral femur and tibia were significantly higher 12 months postoperatively than preoperatively. Conclusions The short-term clinical effects of intra-articular SVF cell injection on knee OA were excellent. Intra-articular SVF cell injection is a novel and innovative approach for treating patients with knee OA.

scholarly journals A Comparison of Dynamic and Static Hip-Knee-Ankle Angle during Gait in Knee Osteoarthritis Patients and Healthy Individuals

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Li Zhang ◽  
Geng Liu ◽  
Bing Han ◽  
Yuzhou Yan ◽  
Junhua Fei ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Healthy Subjects ◽  
Gait Cycle ◽  
Three Dimensional ◽  
Lower Limbs ◽  
Ankle Angle ◽  
The Mean ◽  
The Relationship ◽  
Hip Knee Ankle Angle ◽  
Healthy Participants

Malalignment of the lower limbs is the main biomechanical factor for knee osteoarthritis (KOA). The static hip-knee-ankle angle (S-HKAA) measured from radiograph is regarded as the “gold standard” of the malalignment. However, many evidences showed that the S-HKAA has no significant correlation with the knee dynamic-load distribution, unlike the dynamic HKAA (D-HKAA). The purpose of this study was to quantitatively analyze the D-HKAA and investigate the relationship between D-HKAA and S-HKAA for both KOA and healthy participants. In this paper, twenty-five healthy subjects and twenty-five medial compartment KOA (M-KOA) patients were recruited. Three-dimensional motion analysis and standing lower-limbs-full-length radiograph were utilized to obtain the D-HKAA and S-HKAA, respectively. The results showed that the mean D-HKAA was more varus than the S-HKAA ( p < 0.05 ). For the mean D-HKAA, larger varus angle was observed in swing phase than stance phase ( p < 0.05 ). Compared with healthy subjects, the M-KOA patients had remarkably smaller S-HKAA and D-HKAA during gait cycle ( p < 0.01 ). For the relationship between the S-HKAA and mean D-HKAA, no significant correlation was found for both healthy subjects and M-KOA patients ( r < 0.357 , n = 25 , p > 0.05 , Spearman correlation analysis). In conclusion, the S-HKAA was limited to predict the D-HKAA for both M-KOA patients and healthy subjects. The D-HKAA should be given more attention to the orthopedist and the designer of knee brace and orthotics.

Joint Line Obliquity Does Not Affect the Outcomes of Opening Wedge High Tibial Osteotomy at an Average 10-Year Follow-up

2021 ◽  
pp. 036354652110598
Author(s):  
Federica Rosso ◽  
Roberto Rossi ◽  
Antonino Cantivalli ◽  
Carola Pilone ◽  
Davide Edoardo Bonasia
Keyword(s):  
Joint Line ◽  
Function Score ◽  
Opening Wedge ◽  
Kaplan Meier ◽  
Ankle Angle ◽  
Joint Line Obliquity ◽  
The Mean ◽  
And Function ◽  
Hip Knee Ankle Angle

Background: A significant number of high tibial osteotomies (HTOs) result in an overcorrected tibia and subsequent excessive lateral joint line obliquity (JLO). The correlation between excessive JLO and poor outcomes is controversial. Purpose: To evaluate the prognostic factors (including a pathological postoperative JLO) related with the outcomes of opening wedge HTO at 10 years of follow-up. Study Design: Case series; Level of evidence, 4. Methods: All patients undergoing HTO between 2004 and 2017 for medial osteoarthritis and with a postoperative hip-knee-ankle angle between 176° and 185° were included. Clinical evaluation included Knee Society Score (KSS; knee score and function score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and visual analog scale for pain. Several mechanical and anatomic angles were measured pre- and postoperatively on long-leg weightbearing radiographs. Abnormal JLO was defined as a Mikulicz–joint line angle (MJL) ≥94° or a mechanical medial proximal tibial angle (mMPTA) ≥95°. Regression analysis was performed to evaluate the association between independent variables and each outcome. A Kaplan-Meier cumulative survival analysis was performed. Results: A total of 92 knees in 76 patients were included. The mean age of the patients was 53.5 years (SD, 9.7 years), and the mean follow-up was 129.4 months (SD, 44.4 months). Increased JLO was associated with a significant preoperative varus deformity (small preoperative hip-knee-ankle angle), increased mechanical lateral distal femoral angle, increased joint line congruency angle, and increased knee-ankle joint angle. Male sex was associated with better WOMAC scores ( P = .0277), and increased body mass index (BMI) was associated with inferior WOMAC scores ( P = .0024). A good preoperative range of motion was associated with better knee score ( P = .0399) and function score ( P = .0366) on the KSS. An increased BMI was associated with inferior KSS function scores ( P = .0317). MJL ≥94° and mMPTA ≥95° were not associated with inferior WOMAC or KSS outcomes. With indication to total knee arthroplasty as an endpoint, Kaplan-Meier analysis showed a survival rate of 98.7% at 5 years, 95.5% at 10 years, and 92.7% at 12 years. Conclusion: Increased lateral JLO (MJL ≥94° or mMPTA ≥95°) was not correlated with the clinical outcomes of opening wedge HTO at 10 years of follow-up.

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