单室膝关节置换术中进行关节炎前/运动学对齐的最佳算法髋关节-膝关节-踝关节角度。

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2024-12-06 DOI:10.1016/j.knee.2024.11.013

Kyota Ishibashi , Eiji Sasaki , Shohei Yamauchi , Kento Ota , Ryo Tomita , Hikaru Kristi Ishibashi , Hironori Otsuka , Yasuyuki Ishibashi

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引用次数: 0

摘要

背景：本研究旨在探讨算术髋关节-膝关节-踝关节角（aHKA）是否可以作为外翻应力摄影（VSR）的替代指标。此外，我们研究了术前影像学参数的最佳截止值，从而验证了关节炎前/运动学单室膝关节置换术（prearthritis - uka）的合适纳入标准。方法：我们回顾性分析了123例内侧UKA患者。我们测量了VSR上的HKA，称为sHKA。aHKA通过从胫骨内侧近端角度减去股骨外侧远端角度计算。关节炎前uka定义为术后HKA角度在aHKA 3°以内。我们将患者分为关节炎前期uka组和非关节炎前期uka组。为了评估aHKA是否可以作为VSR的替代指标，在放射学参数之间进行Spearman秩相关。这些影像学参数通过受试者工作特征（ROC）曲线分析和logistic回归分析计算出关节炎前期uka的合适标准。结果：59例患者分为关节炎前期- uka组。aHKA大于sHKA，与sHKA无显著相关。ROC分析显示，检测过校正UKA（即术后HKA - aHKA >.3°）的aHKA截断值为-5.0°。同样，检测未校正的UKA的截止值（即术后HKA - aHKA）结论：aHKA不能作为sHKA的替代品。全面的术前x线评估，包括aHKA和VSR，对于优化UKA结果和最小化不对准风险至关重要。

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Optimal arithmetic hip–knee–ankle angle for performing prearthritic/kinematic alignment in unicompartmental knee arthroplasty

Background

This study aimed to investigate whether arithmetic hip–knee–ankle angle (aHKA) can be a surrogate for valgus stress radiography (VSR). Furthermore, we investigated the optimal cutoff values for preoperative radiographic parameters, thereby validating the appropriate inclusion criteria for prearthritic/kinematic unicompartmental knee arthroplasty (prearthritic-UKA).

Methods

We retrospectively analyzed 123 patients who underwent medial UKA. We measured the HKA on VSR, termed sHKA. The aHKA was calculated by subtracting the lateral distal femoral angle from the medial proximal tibial angle. Prearthritic-UKA was defined as a postoperative HKA angle within 3° of the aHKA. We divided the patients into the prearthritic-UKA and non-prearthritic-UKA groups. To assess whether the aHKA serves as a surrogate for VSR, Spearman’s rank correlations were performed among the radiographic parameters. These radiographic parameters calculated the proper criteria for prearthritic-UKA using receiver operating characteristic (ROC) curve analysis and logistic regression analysis.

Results

Overall, 59 patients were classified into the prearthritic-UKA group. The aHKA was larger than the sHKA and exhibited no significant correlation with the sHKA. ROC analysis revealed that the cutoff values of aHKA for detecting overcorrected UKA (i.e., postoperative HKA – aHKA >3°) was −5.0°. Similarly, the cutoff values for detecting undercorrected UKA (i.e., postoperative HKA – aHKA <−3°) were −3°. Logistic regression analysis revealed that the aHKA was significantly associated with prearthritic-UKA.

Conclusion

The aHKA was not identified as a surrogate for the sHKA. Comprehensive preoperative radiographic assessment, including both aHKA and VSR, is crucial for optimizing UKA outcomes and minimizing risks of misalignment.

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.