Can total knee arthroplasty restore the correlation between radiographic mechanical axis angle and dynamic coronal plane alignment during gait?

Larose, Gabriel; Fuentes, Alexandre; Lavoie, Frédéric; Aïssaoui, Rachid; Guise, Jacques A. de; Hagemeister, Nicola

doi:10.1016/j.knee.2019.02.012

Cited by 8 publications

(8 citation statements)

References 33 publications

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“…In other related post-operation studies, the 6DOF in ground gait suggested that varied static HKA does not correspondingly predict kinematics 23 . It has been shown that minor varus alignment does not compromise the mid-to long-term outcome of a medial UKA with no more than 7°o f varus by analyzing medial xed-bearing UKAs 24 .…”

Section: Discussionmentioning

confidence: 80%

Comparison of Accuracy for HKA by X-ray and Knee Motion Analysis System and the Relationships between HKA and Gait Posture

Zhang

Chen

Jiang

et al. 2021

Preprint

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This study is aimed at obtaining the accuracy of the lower limb mechanical axis (Hip-Knee-Ankle, HKA) by the six degrees of freedom (6DOF) of the knee and ground gait data and analyzing the correlation between the lower limb mechanical axis and 6DOF. We analyzed 3D knee kinematics during ground gait of 99 patients with KOA and 80 patients 6 months after the operations with the vivo infrared navigation 3D portable knee joint movement analysis system (Opti-Knee®, Innomotion Inc, Shanghai, China). Significant correlations with low coefficients (r = -0.19, p = 0.01) between HKA value and anterior-posterior displacement for the whole cohort were found. There were significant correlations with moderate to high coefficients (r = 0.784 to 0.976) between the comparisons of HKA measured on the full-length alignment radiographs and 3D knee joint movement analysis system (Opti-Knee). The further linear correlation analysis showed that there was a significant correlation between the values of HKA measured by X-ray and movement analysis system(R2 = 0.90, p < 0.01). Data with equivalent results as HKA could be provided by knee joint movement analysis system comparing with the conventional X-rays. Nonetheless, there was low significance between the HKA and ground gait data .

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Section: Discussionmentioning

confidence: 80%

Comparison of Accuracy for HKA by X-ray and Knee Motion Analysis System and the Relationships between HKA and Gait Posture

Zhang

Chen

Jiang

et al. 2021

Preprint

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“…Beyond this range, patients may suffer postoperative discomfort and shorten the life of prosthesis [ 9 ]. At present, the gold standard of surgery is still to achieve 0±3°neutral mechanical alignment [ 10 ]. Werner et al [ 11 ] found that when HKA is controlled in the neutral position, the medial and lateral gaps of the knee joint are roughly equal.…”

Section: Introductionmentioning

confidence: 99%

Is Static Alignment a Good Predictor of Dynamic Alignment after Total Knee Arthroplasty?

Mao

Dong

et al. 2022

Healthcare

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Background: Total knee arthroplasty (TKA) is the only effective treatment of end-stage knee osteoarthritis (OA). Lower limb neutral alignment has been a criterion to predict prosthesis life; however, there has been recent controversy over this. Some researchers believe that lower limb static alignment does not significantly affect prosthesis life and some researchers have found that dynamic mechanical alignment may affect prosthesis life, which needs to be further studied. Methods: Eighty-seven patients with knee OA were evaluated by a three-dimensional (3D) gait analysis system before TKA and six months after TKA, dynamic mechanical alignment and basic gait parameters were then calculated. Based on the static alignment of the lower limb on the postoperative X-radiographs, they were divided into a neutral alignment group (58 cases), varus alignment group (20 cases), and valgus alignment group (9 cases). Simple linear regression was used to assess the correlation between static and dynamic alignment. One-way analysis of variance (ANOVA) was used to compare the differences in gait parameters between and within groups. Results: Eighty-seven patients were followed up for an average of six months after the operation. There was no significant difference in all gait parameters among the three groups after TKA. There was no correlation found between static alignment and dynamic alignment/knee adduction moment (KAM) after TKA, although patients showed a significant linear correlation before operation. There was a significant linear correlation between dynamic alignment and KAM before and after the operation. Conclusions: Static alignment has no significant effect on postoperative gait function. Static alignment is no longer an effective predictor of the dynamic alignment or KAM six months after TKA, although they are correlated before TKA. The dynamic alignment allows for better prediction of KAM, which may be a risk factor for the life of the prosthesis.

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“…As the “gold standard” measure of the malalignment, hip-knee-ankle angle (HKAA) measured from a standing lower-limbs-full-length anterior-posterior radiograph provides important guidance for the preoperative diagnosis of orthopedists, surgical planning and assessment of total knee arthroplasty (TKA), design of brace and orthotics, and so on [ 10 – 12 ]. However, some studies pointed out that there was no significant correlation between static HKAA (S-HKAA) and dynamic load distribution of knee joint, which mainly because the S-HKAA was limited to predict the dynamic behavior [ 13 – 16 ]. As an advanced and cutting-edge method, dynamic HKAA (D-HKAA) obtained from gait analysis can accurately and real-time reflect the loading condition of the knee joint and is increasingly used in clinical work [ 15 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the past few years, in order to study the D-HKAA and analyze the relationship between D-HKAA and S-HKAA, a few related researches have been done. Larose et al [ 13 ] investigated the correlation between static radiographic alignment and dynamic motion-capturing alignment during gait for TKA postoperative patients. They pointed out that there was a weak relationship between static and dynamic alignment.…”

Section: Introductionmentioning

confidence: 99%

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

Zhang

Liu

Han

et al. 2021

Applied Bionics and Biomechanics

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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.

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Can total knee arthroplasty restore the correlation between radiographic mechanical axis angle and dynamic coronal plane alignment during gait?

Cited by 8 publications

References 33 publications

Comparison of Accuracy for HKA by X-ray and Knee Motion Analysis System and the Relationships between HKA and Gait Posture

Comparison of Accuracy for HKA by X-ray and Knee Motion Analysis System and the Relationships between HKA and Gait Posture

Is Static Alignment a Good Predictor of Dynamic Alignment after Total Knee Arthroplasty?

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

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