Mohammad Ayati Firoozabadi, Omid Salkhori, Mohammadreza Razzaghof, Hamed Naghizadeh, Sina Aminizadeh, Zainab Saeed Hameed Almutawa, Mohammad Poursalehian, Seyed Mohammad Javad Mortazavi
{"title":"术前下肢对齐角度能否预测膝关节内翻全膝关节置换术中必要的软组织释放？回顾性队列研究。","authors":"Mohammad Ayati Firoozabadi, Omid Salkhori, Mohammadreza Razzaghof, Hamed Naghizadeh, Sina Aminizadeh, Zainab Saeed Hameed Almutawa, Mohammad Poursalehian, Seyed Mohammad Javad Mortazavi","doi":"10.1007/s00264-025-06615-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>A proper balance of soft tissues is essential in total knee arthroplasty (TKA) for varus knees, but assessing soft tissue tension preoperatively is challenging. This study aimed to determine whether lower limb alignment angles can predict the necessary degree of soft tissue release.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 953 patients with varus knees (> 10°) who underwent primary TKA from 2018 to 2020. The patients' data, release stage data, and three-joint alignment radiograph parameters were extracted from the Joint Reconstruction Research Center Knee registry, focusing on variables such as age, sex, body mass index (BMI), femoral mechanical‒anatomical angle (FMAA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), joint line congruent angle (JLCA), and varus angle (VA). Data analysis was performed via SPSS 26.0.</p><p><strong>Results: </strong>The mean age of the patients was 65.4 (43-86) years, with a predominance of females (57.9%). Findings revealed significant associations between soft tissue release and FMAA, LDFA, MPTA, JLCA, MPTA/VA, and JLCA/VA. ROC curve analysis indicated that the JLCA/VA ratio had the highest predictive accuracy (0.997). A cutoff value of 0.49 for JLCA/VA was used to predict the soft tissue release grade, with a sensitivity of 98.8% and specificity of 99.9%.</p><p><strong>Conclusion: </strong>Angular parameters from three-joint alignment radiographs can effectively predict soft tissue release needed for TKA in varus knees, with the JLCA/VA being the most reliable parameter.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2077-2085"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Can preoperative lower limb alignment angles predict necessary soft tissue release during total knee arthroplasty for varus knees? A retrospective cohort study.\",\"authors\":\"Mohammad Ayati Firoozabadi, Omid Salkhori, Mohammadreza Razzaghof, Hamed Naghizadeh, Sina Aminizadeh, Zainab Saeed Hameed Almutawa, Mohammad Poursalehian, Seyed Mohammad Javad Mortazavi\",\"doi\":\"10.1007/s00264-025-06615-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>A proper balance of soft tissues is essential in total knee arthroplasty (TKA) for varus knees, but assessing soft tissue tension preoperatively is challenging. This study aimed to determine whether lower limb alignment angles can predict the necessary degree of soft tissue release.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 953 patients with varus knees (> 10°) who underwent primary TKA from 2018 to 2020. The patients' data, release stage data, and three-joint alignment radiograph parameters were extracted from the Joint Reconstruction Research Center Knee registry, focusing on variables such as age, sex, body mass index (BMI), femoral mechanical‒anatomical angle (FMAA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), joint line congruent angle (JLCA), and varus angle (VA). Data analysis was performed via SPSS 26.0.</p><p><strong>Results: </strong>The mean age of the patients was 65.4 (43-86) years, with a predominance of females (57.9%). Findings revealed significant associations between soft tissue release and FMAA, LDFA, MPTA, JLCA, MPTA/VA, and JLCA/VA. ROC curve analysis indicated that the JLCA/VA ratio had the highest predictive accuracy (0.997). A cutoff value of 0.49 for JLCA/VA was used to predict the soft tissue release grade, with a sensitivity of 98.8% and specificity of 99.9%.</p><p><strong>Conclusion: </strong>Angular parameters from three-joint alignment radiographs can effectively predict soft tissue release needed for TKA in varus knees, with the JLCA/VA being the most reliable parameter.</p>\",\"PeriodicalId\":14450,\"journal\":{\"name\":\"International Orthopaedics\",\"volume\":\" \",\"pages\":\"2077-2085\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00264-025-06615-z\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00264-025-06615-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Can preoperative lower limb alignment angles predict necessary soft tissue release during total knee arthroplasty for varus knees? A retrospective cohort study.
Purpose: A proper balance of soft tissues is essential in total knee arthroplasty (TKA) for varus knees, but assessing soft tissue tension preoperatively is challenging. This study aimed to determine whether lower limb alignment angles can predict the necessary degree of soft tissue release.
Methods: A retrospective cohort study was conducted on 953 patients with varus knees (> 10°) who underwent primary TKA from 2018 to 2020. The patients' data, release stage data, and three-joint alignment radiograph parameters were extracted from the Joint Reconstruction Research Center Knee registry, focusing on variables such as age, sex, body mass index (BMI), femoral mechanical‒anatomical angle (FMAA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), joint line congruent angle (JLCA), and varus angle (VA). Data analysis was performed via SPSS 26.0.
Results: The mean age of the patients was 65.4 (43-86) years, with a predominance of females (57.9%). Findings revealed significant associations between soft tissue release and FMAA, LDFA, MPTA, JLCA, MPTA/VA, and JLCA/VA. ROC curve analysis indicated that the JLCA/VA ratio had the highest predictive accuracy (0.997). A cutoff value of 0.49 for JLCA/VA was used to predict the soft tissue release grade, with a sensitivity of 98.8% and specificity of 99.9%.
Conclusion: Angular parameters from three-joint alignment radiographs can effectively predict soft tissue release needed for TKA in varus knees, with the JLCA/VA being the most reliable parameter.
期刊介绍：
International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters.
Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable.
The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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