A comparison of coronal plane and rotational alignments of the knees between rheumatoid arthritis and osteoarthritis: a retrospective cohort study.

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Kunihito Hirotomi, Shu Takagawa, Yohei Yukizawa, Kengo Harigane, Ken Kumagai, Yuichi Mochida, Yutaka Inaba, Naomi Kobayashi
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引用次数: 0

Abstract

Objectives: Kinematic alignment (KA) in total knee arthroplasty (TKA) has been extensively studied in osteoarthritis (OA) knees but remains unexplored in rheumatoid arthritis (RA) knees. We compared the coronal and rotational alignments in knees with RA and OA.

Methods: In total, 433 patients (69 with RA and 364 with OA) who underwent TKA were included. The hip-knee-ankle angle HKA), lateral distal femoral angle LDFA), medial proximal tibia angle (MPTA), and coronal plane alignment of the knee (CPAK) classification were measured using full length anteroposterior radiographs. The difference between the posterior condylar axis (PCA) and surgical epicondylar axis (SEA) angle was measured with computed tomography.

Results: Patients with RA exhibited different CPAK classifications compared to those with OA. The mean PCA-SEA was significantly different between the RA and OA groups. Furthermore, the RA group had significantly larger HKA, smaller LDFA, and larger MPTA compared to the OA group.

Conclusions: CPAK classification distribution between patients with RA and OA were different. The average PCA-SEA for RA is larger than that for OA, warranting caution of the complications associated with internal rotation placement. Understanding these differences allows for the consideration of RA knee characteristics and informs future evaluations of KA techniques.

类风湿关节炎和骨关节炎患者膝关节冠状面和旋转排列的比较:一项回顾性队列研究。
目的:全膝关节置换术(TKA)中的运动学对齐(KA)已经在骨关节炎(OA)膝关节中得到了广泛的研究,但在类风湿性关节炎(RA)膝关节中仍未得到探索。我们比较了膝关节冠状位和旋转位与RA和OA的关系。方法:共纳入433例经TKA治疗的患者(RA 69例,OA 364例)。采用全长正位x线片测量髋关节-膝关节-踝关节角(HKA)、股骨外侧远端角(LDFA)、胫骨内侧近端角(MPTA)和膝关节冠状面排列(CPAK)分类。通过计算机断层扫描测量后髁轴(PCA)与外科上髁轴(SEA)角度的差异。结果:RA患者与OA患者表现出不同的CPAK分类。RA组和OA组的平均PCA-SEA差异有统计学意义。此外,与OA组相比,RA组的HKA、LDFA和MPTA明显更大。结论:类风湿关节炎与OA患者的CPAK分型分布存在差异。RA的平均PCA-SEA大于OA,需要注意内旋置入相关的并发症。了解这些差异可以考虑RA膝关节特征,并为将来评估KA技术提供信息。
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来源期刊
Modern Rheumatology
Modern Rheumatology RHEUMATOLOGY-
CiteScore
4.90
自引率
9.10%
发文量
146
审稿时长
1.5 months
期刊介绍: Modern Rheumatology publishes original papers in English on research pertinent to rheumatology and associated areas such as pathology, physiology, clinical immunology, microbiology, biochemistry, experimental animal models, pharmacology, and orthopedic surgery. Occasional reviews of topics which may be of wide interest to the readership will be accepted. In addition, concise papers of special scientific importance that represent definitive and original studies will be considered. Modern Rheumatology is currently indexed in Science Citation Index Expanded (SciSearch), Journal Citation Reports/Science Edition, PubMed/Medline, SCOPUS, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, EBSCO, CSA, Academic OneFile, Current Abstracts, Elsevier Biobase, Gale, Health Reference Center Academic, OCLC, SCImago, Summon by Serial Solutions
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