Fabio Mancino, Joshua G Twiggs, Ishaan Jagota, Brett A Fritsch
{"title":"数据打败教条——外翻膝与股骨外侧髁发育不全无关：来自一个大容量机构的基于ct的分析。","authors":"Fabio Mancino, Joshua G Twiggs, Ishaan Jagota, Brett A Fritsch","doi":"10.1002/ksa.12688","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Observations following the mechanical alignment principle have led to the concept that the lateral femoral condyle (LFC) is hypoplastic in valgus knee. This study aimed to investigate if this assumption is correct-the hypothesis was that there is no relationship between the radius of curvature of the LFC and coronal alignment.</p><p><strong>Methods: </strong>This is a retrospective study of prospectively collected patients who underwent primary robotic TKA between 2021 and 2023. Segmentation of the preoperative computerised tomography scan was performed to obtain a three-dimensional model of the knee. A semi-automated algorithm was used to create a circle of best fit to obtain the radius of each femoral condyle. The size of the condyles was expressed as the lateral-to-medial (L2M) condylar radii ratio. Patients were stratified based on hip-knee-ankle (HKA) angle and L2M ratio, and the association with the alignment was analysed. Distal and posterior offset were investigated and analysed. Significance was for p values < 0.05.</p><p><strong>Results: </strong>Overall, 498 consecutive knees were investigated. The mean HKA was 4.1 ± 5.4° varus. The mean L2M condylar ratio was 0.95 in patients with neutral alignment, 0.98 in varus alignment and 0.96 in valgus alignment. The L2M ratio was <1 in all alignment groups, with no significant differences between varus and valgus. The knees with a hypoplastic LFC (L2M ratio <0.9) showed a similar HKA distribution to those with L2M > 0.9. No differences in posterior offset of the LFC were noted between valgus, neutral and varus knees. The lateral distal offset was greater in valgus than neutral knees (27.1 ± 2.7 mm vs. 25.9 ± 2.9 mm).</p><p><strong>Conclusion: </strong>The LFC is on average smaller than the MFC regardless of the coronal alignment, with no correlation with the HKA. These findings add evidence against the concept of a hypoplastic LFC in valgus knees.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Data beats dogma-Valgus knees are not associated with a hypoplastic lateral femoral condyle: A CT-based analysis from a high-volume institution.\",\"authors\":\"Fabio Mancino, Joshua G Twiggs, Ishaan Jagota, Brett A Fritsch\",\"doi\":\"10.1002/ksa.12688\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Observations following the mechanical alignment principle have led to the concept that the lateral femoral condyle (LFC) is hypoplastic in valgus knee. This study aimed to investigate if this assumption is correct-the hypothesis was that there is no relationship between the radius of curvature of the LFC and coronal alignment.</p><p><strong>Methods: </strong>This is a retrospective study of prospectively collected patients who underwent primary robotic TKA between 2021 and 2023. Segmentation of the preoperative computerised tomography scan was performed to obtain a three-dimensional model of the knee. A semi-automated algorithm was used to create a circle of best fit to obtain the radius of each femoral condyle. The size of the condyles was expressed as the lateral-to-medial (L2M) condylar radii ratio. Patients were stratified based on hip-knee-ankle (HKA) angle and L2M ratio, and the association with the alignment was analysed. Distal and posterior offset were investigated and analysed. Significance was for p values < 0.05.</p><p><strong>Results: </strong>Overall, 498 consecutive knees were investigated. The mean HKA was 4.1 ± 5.4° varus. The mean L2M condylar ratio was 0.95 in patients with neutral alignment, 0.98 in varus alignment and 0.96 in valgus alignment. The L2M ratio was <1 in all alignment groups, with no significant differences between varus and valgus. The knees with a hypoplastic LFC (L2M ratio <0.9) showed a similar HKA distribution to those with L2M > 0.9. No differences in posterior offset of the LFC were noted between valgus, neutral and varus knees. The lateral distal offset was greater in valgus than neutral knees (27.1 ± 2.7 mm vs. 25.9 ± 2.9 mm).</p><p><strong>Conclusion: </strong>The LFC is on average smaller than the MFC regardless of the coronal alignment, with no correlation with the HKA. These findings add evidence against the concept of a hypoplastic LFC in valgus knees.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>\",\"PeriodicalId\":17880,\"journal\":{\"name\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-05-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12688\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12688","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Data beats dogma-Valgus knees are not associated with a hypoplastic lateral femoral condyle: A CT-based analysis from a high-volume institution.
Purpose: Observations following the mechanical alignment principle have led to the concept that the lateral femoral condyle (LFC) is hypoplastic in valgus knee. This study aimed to investigate if this assumption is correct-the hypothesis was that there is no relationship between the radius of curvature of the LFC and coronal alignment.
Methods: This is a retrospective study of prospectively collected patients who underwent primary robotic TKA between 2021 and 2023. Segmentation of the preoperative computerised tomography scan was performed to obtain a three-dimensional model of the knee. A semi-automated algorithm was used to create a circle of best fit to obtain the radius of each femoral condyle. The size of the condyles was expressed as the lateral-to-medial (L2M) condylar radii ratio. Patients were stratified based on hip-knee-ankle (HKA) angle and L2M ratio, and the association with the alignment was analysed. Distal and posterior offset were investigated and analysed. Significance was for p values < 0.05.
Results: Overall, 498 consecutive knees were investigated. The mean HKA was 4.1 ± 5.4° varus. The mean L2M condylar ratio was 0.95 in patients with neutral alignment, 0.98 in varus alignment and 0.96 in valgus alignment. The L2M ratio was <1 in all alignment groups, with no significant differences between varus and valgus. The knees with a hypoplastic LFC (L2M ratio <0.9) showed a similar HKA distribution to those with L2M > 0.9. No differences in posterior offset of the LFC were noted between valgus, neutral and varus knees. The lateral distal offset was greater in valgus than neutral knees (27.1 ± 2.7 mm vs. 25.9 ± 2.9 mm).
Conclusion: The LFC is on average smaller than the MFC regardless of the coronal alignment, with no correlation with the HKA. These findings add evidence against the concept of a hypoplastic LFC in valgus knees.
Level of evidence: Level III, retrospective cohort study.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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