scholarly journals Osteoarthritic and non-osteoarthritic patients show comparable coronal knee joint line orientations in a cross-sectional study based on 3D reconstructed CT images

2021 ◽  
Author(s):  
Silvan Hess ◽  
Lukas B. Moser ◽  
Emma L. Robertson ◽  
Henrik Behrend ◽  
Felix Amsler ◽  
...  
Keyword(s):  
Lower Limb ◽  
Joint Line ◽  
Line Orientation ◽  
Published Data ◽  
Detailed Knowledge ◽  
Limb Alignment ◽  
Coronal Alignment ◽  
Lower Limb Alignment ◽  
Cross Sectional ◽  
Mean Values

Abstract Purpose Recently introduced total knee arthroplasty (TKA) alignment strategies aim to restore the pre-arthritic alignment of an individual patient. The native alignment of a patient can only be restored with detailed knowledge about the native and osteoarthritic alignment as well as differences between them. The first aim of this study was to assess the alignment of a large series of osteoarthritic (OA) knees and investigate whether femoral and tibial joint lines vary within patients with the same overall lower limb alignment. The secondary aim was to compare the alignment of OA patients to the previously published data of non-OA patients. This information could be useful for surgeons considering implementing one of the new alignment concepts. Material Coronal alignment parameters of 2692 knee OA patients were measured based on 3D reconstructed CT data using a validated planning software (Knee-PLAN®, Symbios, Yverdon les Bains, Switzerland). Based on these measurements, patients' coronal alignment was phenotyped according to the functional knee phenotype concept. These phenotypes represent an alignment variation of either the overall alignment, the femoral joint line orientation or the tibial joint line orientation. Each phenotype is defined by a specific mean and covers a range of ± 1.5° from this mean. Mean values and distribution among the phenotypes are presented and compared between two populations (OA patients of this study and non-OA patients of a previously published study) as well as between HKA subgroups (varus, valgus and neutral) using t tests and Chi-square tests (p < 0.05). Results Femoral and tibial joint lines varied within patients with the same overall lower limb alignment. A total of 162 functional knee phenotypes were found (119 males, 136 females and 94 mutual phenotypes). Mean values differed between the OA and non-OA population, but differences were small (< 2°) except for the overall alignment (e.g. HKA). The distribution of OA and non-OA patients among the phenotypes differed significantly, especially among the limb phenotypes. Conclusion Differences between OA and non-OA knees are small regarding coronal femoral and tibial joint line orientation. Femoral and tibial joint line orientation of osteoarthritic patients can, therefore, be used to estimate their native coronal alignment and plan an individualized knee alignment. Level of clinical evidence III.

scholarly journals Changes in Coronal Alignment of the Knee Joint after Supramalleolar Osteotomy

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Dong-Il Chun ◽  
Jahyung Kim ◽  
Sung Hun Won ◽  
Jaeho Cho ◽  
Jeongku Ha ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Knee Joint ◽  
Ankle Joint ◽  
Lower Limb ◽  
Varus Deformity ◽  
Limb Alignment ◽  
Coronal Alignment ◽  
Lower Limb Alignment ◽  
Radiographic Parameters ◽  
Supramalleolar Osteotomy

Background. Assessing knee joint orientation changes after SMO may help clinical advancement in managing patients with ipsilateral ankle and knee joint arthritis. However, knee joint changes after supramalleolar osteotomy (SMO) have not been reported. We investigated changes in coronal alignment of the knee joint after SMO. Methods. In this multicentre study, from January 2014 to December 2018, 47 ankles with varus osteoarthritis treated with SMO were retrospectively identified. Ankle joint changes were assessed using the tibiotalar angle, talar tilt angle, and lateral distal tibial angle (LDTA); knee joint changes using the medial proximal tibial angle (MPTA), medial and lateral joint space widths (mJSW and lJSW, respectively), and medial and lateral joint line convergence angles (JLCA); and lower limb alignment changes using mechanical axis deviation angle (MADA) and the hip-knee-ankle (HKA) angle measured on full-length anteroposterior radiographs of the lower extremity. Correlation analysis and binary logistic regression analysis were performed. Results. Postoperatively, LDTA ( p < 0.001 ) and tibiotalar angle ( p < 0.001 ) significantly changed, indicating meaningful improvement in the ankle joint varus deformity. Regarding the knee joint changes, JLCA significantly changed into valgus direction ( p = 0.044 ). As for lower limb alignment changes, MADA significantly decreased ( p < 0.001 ), whereas the HKA angle significantly increased ( p < 0.001 ). In univariate and multivariate logistic regression analyses, changes in the MADA ( p < 0.001 ) and the HKA angle ( p < 0.001 ) were significantly correlated with the correction angle. Conclusions. SMO remarkably improves ankle joint varus deformity, followed by significant lower limb alignment changes. Despite meaningful changes in JLCA, the relationship between the amount of osteotomy near the ankle joint and improvement in knee joint radiographic parameters was not significant. Radiographic parameters of the knee joint would less likely be changed following SMO.

scholarly journals KINANTHROPOLOGICAL ANALYSIS OF THE CORE

2020 ◽  
pp. 335
Author(s):  
Strahinja Nikolić ◽  
Zlatko Ahmetović ◽  
Zoran Đokić
Keyword(s):  
Lower Limb ◽  
Scientific Journal ◽  
Lumbar Region ◽  
Sports Performance ◽  
Journal Articles ◽  
Limb Alignment ◽  
Lower Limb Alignment ◽  
The Core ◽  
Morphological Status ◽  
Lumbar Stabilization

The aim of this research is to investigate existing research dealing with the topic of the structure, functional and morphological status of the muscles that make up the body's core, as well as how improving the core affects the advancement of sports technique and its efficiency. The term core most commonly refers to the trunk, or more precisely, to the lumbar region. Core muscles play a significant role in lower limb alignment and stability, associated with poor alignment and injuries. The development of the core strength to improve the efficiency of sports performance is a controversial issue that has yielded different results. The analysis of the scientific journal articles revealed that the specificity of the program for increasing lumbar stabilization with the appropriate sport or skill is of the utmost importance. Therefore, it is necessary to specialize training facilities so that they are suited to a specific sport branch or discipline.

Variable Lower Limb Alignment of Clinical Measures With Digital Photographs and the Footscan Pressure System

2020 ◽  
pp. 1-8
Author(s):  
Figen Govsa ◽  
Gkionoul Nteli Chatzioglou ◽  
Simin Hepguler ◽  
Yelda Pinar ◽  
Ozden Bedre
Keyword(s):  
Lower Limb ◽  
Plantar Pressure ◽  
Subtalar Joint ◽  
Positive Contribution ◽  
Digital Photogrammetry ◽  
Limb Alignment ◽  
Lower Limb Alignment ◽  
Measuring Device ◽  
Joint Flexibility ◽  
Pressure Measuring Device

Objective: This study examines the effect of the lower limb misalignment and its possible compensatory effect on plantar pressure in a normal population. The aim of this paper is to present a structured method for the analysis of posture and its changes using a standardized digital photography technique and plantar pressure measuring device. Design: Cohort. Setting: Laboratory. Participants: A total of 200 adult volunteers between 18 and 22 years of age who had no current symptoms of pain and foot or ankle pathology participated in the study. Main Outcome Measures: The gold standard measure of lower limb alignment with weight-bearing status is the mechanical axis and their angles using Image J software. Structural and functional measurements of the same foot were taken using a plantar pressure measuring device. In this study, 5 alignment (thigh, knee, leg, ankle, and foot) characteristics were measured on the lower limb using the 2 techniques, and, additionally, the foot contact area, peak pressure, foot axis, rearfoot angle, and subtalar joint flexibility score were analyzed in 10 different regions of the foot. Results: This study has shown a reasonable correlation between digitalized measurements and plantar pressures values. Quadriceps angle affected midfoot impulse, foot axis angle, subtalar joint minimum angle, and rearfoot angle positively. Subtalar joint flexibility scores were analyzed in 10 different regions of the foot. There was a positive correlation between rearfoot angle and quadriceps angle (P = .009, r = .261). Results of both methods show that they endorse each other. Conclusions: The posture of the standing feet may have influence on lower limb alignment. Currently, there are no studies carried out by using digital photogrammetry and foot scan. The authors claim that patient-friendly digital photogrammetry would have a positive contribution to the monitoring of patients, even including new ones in the treatment programs, reducing any possible loss in the personal and national economy.

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