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Erschienen in: Clinical Orthopaedics and Related Research® 5/2013

01.05.2013 | Symposium: Special Considerations for TKA in Asian Patients

Distal Femur Rotation Relates to Joint Obliquity in ACL-deficient Chinese

verfasst von: W. P. Yau, MBBS, FRCSE, FHKCOS, K. Y. Chiu, MBBS, FRCSE, FHKCOS, August W. M. Fok, MBChB, FRCSE, FHKCOS, C. H. Yan, MBBS, FRCSE, FHKCOS, F. Y. Ng, MBBS, FRCSE, FHKCOS

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 5/2013

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Abstract

Background

The lower limb osteometry of Chinese differs from that of whites. The joint line of the knee in the coronal plane in Chinese is more medially inclined and the posterior condylar angle of the distal femur in the axial plane is larger. However, it is unclear whether there is any direct association between the coronal plane and axial plane osteometry.

Questions/purposes

We asked whether the joint line obliquity of the knee is related to the posterior condylar angle of the distal femur in young Chinese subjects.

Methods

Ninety-nine young Chinese patients with anterior cruciate ligament injuries were recruited. The lower limb alignment and joint line obliquity were measured using standing long radiographs of the whole lower limb. The rotational alignment of the distal femur was assessed in the axial cuts of the MRI.

Results

The distal femur rotational alignment was associated with the obliquity of the knee in Chinese. The posterior condylar angle was 5° ± 2°. The knee was 5° ± 3° medially inclined.

Conclusions

The joint line of the knee in a group of young Chinese patients was more medially inclined than that of whites. The posterior condylar angle of the distal femur was larger. The presence of an association between distal femur rotational alignment and joint line obliquity in this group of young Chinese patients suggests a possible developmental cause explaining the difference in osteometry between races.
Literatur
1.
Zurück zum Zitat Akagi M, Matsusue Y, Mata T, Asada Y, Horiguchi M, Iida H, Nakamura T. Effect of rotational alignment on patellar tracking in total knee arthroplasty. Clin Orthop Relat Res. 1999;366:155–163.PubMedCrossRef Akagi M, Matsusue Y, Mata T, Asada Y, Horiguchi M, Iida H, Nakamura T. Effect of rotational alignment on patellar tracking in total knee arthroplasty. Clin Orthop Relat Res. 1999;366:155–163.PubMedCrossRef
2.
Zurück zum Zitat Berger RA, Crossett LS, Jacobs JJ, Rubash HE. Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res. 1998;356:144–153.PubMedCrossRef Berger RA, Crossett LS, Jacobs JJ, Rubash HE. Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res. 1998;356:144–153.PubMedCrossRef
3.
Zurück zum Zitat Berger RA, Rubash HE, Seel MJ, Thompson WH, Crossett LS. Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res. 1993;286:40–47.PubMed Berger RA, Rubash HE, Seel MJ, Thompson WH, Crossett LS. Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res. 1993;286:40–47.PubMed
4.
Zurück zum Zitat Chiu KY, Zhang SD, Zhang GH. Posterior slope of tibial plateau in Chinese. J Arthroplasty. 2000;15:224–227.PubMedCrossRef Chiu KY, Zhang SD, Zhang GH. Posterior slope of tibial plateau in Chinese. J Arthroplasty. 2000;15:224–227.PubMedCrossRef
5.
Zurück zum Zitat Griffin FM, Math K, Scuderi GR, Insall JN, Poilvache PL. Anatomy of the epicondyles of the distal femur. MRI analysis of normal knees. J Arthroplasty. 2000;15:354–359.PubMedCrossRef Griffin FM, Math K, Scuderi GR, Insall JN, Poilvache PL. Anatomy of the epicondyles of the distal femur. MRI analysis of normal knees. J Arthroplasty. 2000;15:354–359.PubMedCrossRef
6.
Zurück zum Zitat Hood RW, Vanni M, Insall JN. The correction of knee alignment in 225 consecutive total condylar knee replacements. Clin Orthop Relat Res. 1981;160:94–105.PubMed Hood RW, Vanni M, Insall JN. The correction of knee alignment in 225 consecutive total condylar knee replacements. Clin Orthop Relat Res. 1981;160:94–105.PubMed
7.
Zurück zum Zitat Hsu RWW, Himeno S, Coventry MB, Chao EYS. Normal axial alignment of the lower limb and load-bearing distribution at the knee. Clin Orthop Relat Res. 1990;255:215–227.PubMed Hsu RWW, Himeno S, Coventry MB, Chao EYS. Normal axial alignment of the lower limb and load-bearing distribution at the knee. Clin Orthop Relat Res. 1990;255:215–227.PubMed
8.
Zurück zum Zitat Insall JN, Binazzi R, Soudry M, Mestriner LA. Total knee arthroplasty. Clin Orthop Relat Res. 1985;192:13–22.PubMed Insall JN, Binazzi R, Soudry M, Mestriner LA. Total knee arthroplasty. Clin Orthop Relat Res. 1985;192:13–22.PubMed
9.
Zurück zum Zitat Jiang CC, Insall JN. Effect of rotation on the axial alignment of the femur. Pitfalls in the use of femoral intramedullary guides in total knee arthroplasty. Clin Orthop Relat Res. 1989;248:50–56.PubMed Jiang CC, Insall JN. Effect of rotation on the axial alignment of the femur. Pitfalls in the use of femoral intramedullary guides in total knee arthroplasty. Clin Orthop Relat Res. 1989;248:50–56.PubMed
10.
Zurück zum Zitat Kellegren JH, Lawrence JS. Radiological assessment of osteoarthritis. Ann Rheum Dis. 1957;16:494–501.CrossRef Kellegren JH, Lawrence JS. Radiological assessment of osteoarthritis. Ann Rheum Dis. 1957;16:494–501.CrossRef
11.
Zurück zum Zitat Ko PS, Tio MK, Ban CM, Mak YK, Ip FK, Lam JJ. Radiologic analysis of the tibial intramedullary canal in Chinese varus knees: implications in total knee arthroplasty. J Arthroplasty. 2001;16:212–215.PubMedCrossRef Ko PS, Tio MK, Ban CM, Mak YK, Ip FK, Lam JJ. Radiologic analysis of the tibial intramedullary canal in Chinese varus knees: implications in total knee arthroplasty. J Arthroplasty. 2001;16:212–215.PubMedCrossRef
12.
Zurück zum Zitat Lie CWH, Yau WP, Chiu KY, Leung HB, Wong LLS, Wong SHM. Interobserver and intraobserver error in distal femur transepicondylar axis measurement with computed tomography. J Arthroplasty. 2009;24:96–100.CrossRef Lie CWH, Yau WP, Chiu KY, Leung HB, Wong LLS, Wong SHM. Interobserver and intraobserver error in distal femur transepicondylar axis measurement with computed tomography. J Arthroplasty. 2009;24:96–100.CrossRef
13.
Zurück zum Zitat Lohmander LS, Ostenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum. 2004;50:3145–3152.PubMedCrossRef Lohmander LS, Ostenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum. 2004;50:3145–3152.PubMedCrossRef
14.
Zurück zum Zitat Moreland JR, Bassett LW, Hanker GJ. Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am. 1987;69:745–749.PubMed Moreland JR, Bassett LW, Hanker GJ. Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am. 1987;69:745–749.PubMed
15.
Zurück zum Zitat Neuman P, Englund M, Kostogiannis I, Friden T, Roos H, Dahlberg LE. Prevalence of tibiofemoral osteoarthritis 15 years after nonoperative treatment of anterior cruciate ligament injury: a prospective cohort study. Am J Sports Med. 2008;36:1717–1725.PubMedCrossRef Neuman P, Englund M, Kostogiannis I, Friden T, Roos H, Dahlberg LE. Prevalence of tibiofemoral osteoarthritis 15 years after nonoperative treatment of anterior cruciate ligament injury: a prospective cohort study. Am J Sports Med. 2008;36:1717–1725.PubMedCrossRef
16.
Zurück zum Zitat Neuman P, Kostogiannis I, Friden T, Roos H, Dahlberg LE, Englund M. Patellofemoral osteoarthritis 15 years after anterior cruciate ligament injury—a prospective cohort study. Osteoarthritis Cartilage. 2009;17:284–290.PubMedCrossRef Neuman P, Kostogiannis I, Friden T, Roos H, Dahlberg LE, Englund M. Patellofemoral osteoarthritis 15 years after anterior cruciate ligament injury—a prospective cohort study. Osteoarthritis Cartilage. 2009;17:284–290.PubMedCrossRef
17.
Zurück zum Zitat Oiestad BE, Engebretsen L, Storheim K, Risberg MA. Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med. 2009;37:1434–1443.PubMedCrossRef Oiestad BE, Engebretsen L, Storheim K, Risberg MA. Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med. 2009;37:1434–1443.PubMedCrossRef
18.
Zurück zum Zitat Ritter MA, Faris PM, Keating EM, Meding JB. Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop Relat Res. 1994;299:153–156.PubMed Ritter MA, Faris PM, Keating EM, Meding JB. Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop Relat Res. 1994;299:153–156.PubMed
19.
Zurück zum Zitat Tang WM, Chiu KY, Kwan MF, Ng TP, Yau WP. Sagittal bowing of the distal femur in Chinese patients who require total knee arthroplasty. J Orthop Res. 2005;23:41–45.PubMedCrossRef Tang WM, Chiu KY, Kwan MF, Ng TP, Yau WP. Sagittal bowing of the distal femur in Chinese patients who require total knee arthroplasty. J Orthop Res. 2005;23:41–45.PubMedCrossRef
20.
Zurück zum Zitat Tang WM, Zhu YH, Chiu KY. Axial alignment of the lower extremity in Chinese patients. J Bone Joint Surg Am. 2000;82:1603–1608.PubMed Tang WM, Zhu YH, Chiu KY. Axial alignment of the lower extremity in Chinese patients. J Bone Joint Surg Am. 2000;82:1603–1608.PubMed
21.
Zurück zum Zitat Yau WP, Chiu KY, Tang WM. Computer Navigation did not improve alignment in a lower-volume total knee practice. Clin Orthop Relat Res. 2008;466:935–945.PubMedCrossRef Yau WP, Chiu KY, Tang WM. Computer Navigation did not improve alignment in a lower-volume total knee practice. Clin Orthop Relat Res. 2008;466:935–945.PubMedCrossRef
22.
Zurück zum Zitat Yau WP, Chiu KY, Tang WM, Ng TP. Coronal bowing of the femur and tibia in Chinese: its incidence and effects on total knee arthroplasty planning. J Orthop Surg (Hong Kong). 2007;15:32–36. Yau WP, Chiu KY, Tang WM, Ng TP. Coronal bowing of the femur and tibia in Chinese: its incidence and effects on total knee arthroplasty planning. J Orthop Surg (Hong Kong). 2007;15:32–36.
23.
Zurück zum Zitat Yip DK, Zhu YH, Chiu KY, Ng TP. Distal rotational alignment of the Chinese femur and its relevance in total knee arthroplasty. J Arthroplasty. 2004;19:613–619.PubMedCrossRef Yip DK, Zhu YH, Chiu KY, Ng TP. Distal rotational alignment of the Chinese femur and its relevance in total knee arthroplasty. J Arthroplasty. 2004;19:613–619.PubMedCrossRef
Metadaten
Titel
Distal Femur Rotation Relates to Joint Obliquity in ACL-deficient Chinese
verfasst von
W. P. Yau, MBBS, FRCSE, FHKCOS
K. Y. Chiu, MBBS, FRCSE, FHKCOS
August W. M. Fok, MBChB, FRCSE, FHKCOS
C. H. Yan, MBBS, FRCSE, FHKCOS
F. Y. Ng, MBBS, FRCSE, FHKCOS
Publikationsdatum
01.05.2013
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 5/2013
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2698-4

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