Knee joint line orientation after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb according to foot position
Purpose: Knee joint line orientation (KJLO), an essential component of knee kinematics, has recently been of interest as a clinical parameter, but the factors that determine this are unknown. This study aims to clarify the effect of mechanical axis inclination of the lower limb on KJLO after total k...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-12-01
|
| Series: | Journal of Joint Surgery and Research |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949705123000154 |
| _version_ | 1797235456433192960 |
|---|---|
| author | Shuji Toyono Akemi Suzuki Taku Nakajima Yoshihiro Wanezaki Masashi Aso Takao Yamamoto Takashi Ito Shigenobu Fukushima Michiaki Takagi |
| author_facet | Shuji Toyono Akemi Suzuki Taku Nakajima Yoshihiro Wanezaki Masashi Aso Takao Yamamoto Takashi Ito Shigenobu Fukushima Michiaki Takagi |
| author_sort | Shuji Toyono |
| collection | DOAJ |
| description | Purpose: Knee joint line orientation (KJLO), an essential component of knee kinematics, has recently been of interest as a clinical parameter, but the factors that determine this are unknown. This study aims to clarify the effect of mechanical axis inclination of the lower limb on KJLO after total knee arthroplasty. Methods: The study included 95 knees of 95 patients who underwent kinematically aligned total knee arthroplasty in which two postoperative whole-leg standing radiographs (open and closed stance) were evaluated. We measured hip-knee-ankle angle, mechanical lateral distal femoral angle, medial proximal tibial angle, KJLO, joint line convergence angle, ankle joint line orientation and the inclination angle of lower limb mechanical axis (θ); the amount of change in each measurement was defined as delta (Δ). The correlation between ΔKJLO and each measured value was analysed, and a multiple linear regression analysis was performed to identify significant factors related to ΔKJLO. Results: The open and closed stance radiographs had differences in KJLO (3.4 ± 2.2° vs. −0.2 ± 2.3°,p < 0.001), ankle joint line orientation (−3.3 ± 4.4° vs. −6.8 ± 4.1°, p < 0.001) and θ (−0.3 ± 1.6 vs. 3.3 ± 1.5, p < 0.001). We found that Δθ determined ΔKJLO, with a strong negative correlation (r = −0.847, p < 0.001). According to the ΔKJLO equation, ΔKJLO (°) = 0.361 − 0.898 × θ (°), KJLO changed by 0.9° per 1° of θ. Conclusion: The KJLO after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb; KJLO changed by 0.9° per 1° of θ. |
| first_indexed | 2024-04-24T16:48:15Z |
| format | Article |
| id | doaj.art-4123c84c9fd54d3eb15f50a6b84c1486 |
| institution | Directory Open Access Journal |
| issn | 2949-7051 |
| language | English |
| last_indexed | 2024-04-24T16:48:15Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Joint Surgery and Research |
| spelling | doaj.art-4123c84c9fd54d3eb15f50a6b84c14862024-03-29T05:51:49ZengElsevierJournal of Joint Surgery and Research2949-70512023-12-0111123127Knee joint line orientation after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb according to foot positionShuji Toyono0Akemi Suzuki1Taku Nakajima2Yoshihiro Wanezaki3Masashi Aso4Takao Yamamoto5Takashi Ito6Shigenobu Fukushima7Michiaki Takagi8Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan; Department of Orthopaedic Surgery, Saiseikai Yamagata Saisei Hospital, Yamagata, 990-8545, Japan; Corresponding author. 2-2-2, Iida-Nishi, Yamagata 990-9585, JapanDepartment of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, 990-9585, JapanDepartment of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, 990-9585, JapanDepartment of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, 990-9585, JapanDepartment of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, 990-9585, JapanDepartment of Orthopaedic Surgery, Saiseikai Yamagata Saisei Hospital, Yamagata, 990-8545, JapanDepartment of Orthopaedic Surgery, Saiseikai Yamagata Saisei Hospital, Yamagata, 990-8545, JapanDepartment of Orthopaedic Surgery, Saiseikai Yamagata Saisei Hospital, Yamagata, 990-8545, JapanDepartment of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, 990-9585, JapanPurpose: Knee joint line orientation (KJLO), an essential component of knee kinematics, has recently been of interest as a clinical parameter, but the factors that determine this are unknown. This study aims to clarify the effect of mechanical axis inclination of the lower limb on KJLO after total knee arthroplasty. Methods: The study included 95 knees of 95 patients who underwent kinematically aligned total knee arthroplasty in which two postoperative whole-leg standing radiographs (open and closed stance) were evaluated. We measured hip-knee-ankle angle, mechanical lateral distal femoral angle, medial proximal tibial angle, KJLO, joint line convergence angle, ankle joint line orientation and the inclination angle of lower limb mechanical axis (θ); the amount of change in each measurement was defined as delta (Δ). The correlation between ΔKJLO and each measured value was analysed, and a multiple linear regression analysis was performed to identify significant factors related to ΔKJLO. Results: The open and closed stance radiographs had differences in KJLO (3.4 ± 2.2° vs. −0.2 ± 2.3°,p < 0.001), ankle joint line orientation (−3.3 ± 4.4° vs. −6.8 ± 4.1°, p < 0.001) and θ (−0.3 ± 1.6 vs. 3.3 ± 1.5, p < 0.001). We found that Δθ determined ΔKJLO, with a strong negative correlation (r = −0.847, p < 0.001). According to the ΔKJLO equation, ΔKJLO (°) = 0.361 − 0.898 × θ (°), KJLO changed by 0.9° per 1° of θ. Conclusion: The KJLO after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb; KJLO changed by 0.9° per 1° of θ.http://www.sciencedirect.com/science/article/pii/S2949705123000154Knee joint line orientationTotal knee arthroplastyRadiographsLower limb mechanical axis inclination angleStanceKinematic alignment |
| spellingShingle | Shuji Toyono Akemi Suzuki Taku Nakajima Yoshihiro Wanezaki Masashi Aso Takao Yamamoto Takashi Ito Shigenobu Fukushima Michiaki Takagi Knee joint line orientation after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb according to foot position Journal of Joint Surgery and Research Knee joint line orientation Total knee arthroplasty Radiographs Lower limb mechanical axis inclination angle Stance Kinematic alignment |
| title | Knee joint line orientation after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb according to foot position |
| title_full | Knee joint line orientation after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb according to foot position |
| title_fullStr | Knee joint line orientation after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb according to foot position |
| title_full_unstemmed | Knee joint line orientation after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb according to foot position |
| title_short | Knee joint line orientation after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb according to foot position |
| title_sort | knee joint line orientation after total knee arthroplasty is affected by the mechanical axis inclination of the lower limb according to foot position |
| topic | Knee joint line orientation Total knee arthroplasty Radiographs Lower limb mechanical axis inclination angle Stance Kinematic alignment |
| url | http://www.sciencedirect.com/science/article/pii/S2949705123000154 |
| work_keys_str_mv | AT shujitoyono kneejointlineorientationaftertotalkneearthroplastyisaffectedbythemechanicalaxisinclinationofthelowerlimbaccordingtofootposition AT akemisuzuki kneejointlineorientationaftertotalkneearthroplastyisaffectedbythemechanicalaxisinclinationofthelowerlimbaccordingtofootposition AT takunakajima kneejointlineorientationaftertotalkneearthroplastyisaffectedbythemechanicalaxisinclinationofthelowerlimbaccordingtofootposition AT yoshihirowanezaki kneejointlineorientationaftertotalkneearthroplastyisaffectedbythemechanicalaxisinclinationofthelowerlimbaccordingtofootposition AT masashiaso kneejointlineorientationaftertotalkneearthroplastyisaffectedbythemechanicalaxisinclinationofthelowerlimbaccordingtofootposition AT takaoyamamoto kneejointlineorientationaftertotalkneearthroplastyisaffectedbythemechanicalaxisinclinationofthelowerlimbaccordingtofootposition AT takashiito kneejointlineorientationaftertotalkneearthroplastyisaffectedbythemechanicalaxisinclinationofthelowerlimbaccordingtofootposition AT shigenobufukushima kneejointlineorientationaftertotalkneearthroplastyisaffectedbythemechanicalaxisinclinationofthelowerlimbaccordingtofootposition AT michiakitakagi kneejointlineorientationaftertotalkneearthroplastyisaffectedbythemechanicalaxisinclinationofthelowerlimbaccordingtofootposition |