Background: Several researchers consider the clinical epicondylar axis (CEA) as the functional flexion-extension axis of the knee. The anterior pelvic plane (APP) is commonly used as an anatomical reference plane of t...Background: Several researchers consider the clinical epicondylar axis (CEA) as the functional flexion-extension axis of the knee. The anterior pelvic plane (APP) is commonly used as an anatomical reference plane of the pelvis. However, no study has investigated the relationship of the APP with the CEA and PCA. In this study, we aimed to investigate the relationship of the APP with the CEA and posterior condylar axis (PCA) in the standing and supine positions. Methods: We recruited 77 healthy Japanese subjects for this study, and carried out measurements using the Hip CAS?system, a 3D system used for the assessment of lower extremity alignment. Results: The mean femoral neck anteversion was 16.33°. There was an approximate discrepancy of 6° between the male and the female in anatomy (15.73° and 21.15° in the male and female subjects, respectively). The mean condylar twist angle (CTA) was 6.86° and the mean APP-PCA value in the standing position was ﹣6.88°. The mean APP-CEA value in the standing position was 0.02°, and the discrepancy between males and females was only 0.21° (0.09° and ﹣0.13° for the male and female subjects, respectively). This meant that Xp axis of APP and CEA were almost parallel. On the other hand, the mean APP-CEA value in the supine position was 7.07° (male subjects = 9.48°;female subjects = 5.62°). Here, the CEA was approximately parallel to the horizontal axis of the APP, which was compatible with the neutral position of the knee and hip joint, and anatomically and kinesiologically justified in normal subjects. Conclusion: CEA was approximately parallel to the horizontal axis of the APP. These results are compatible with regard to the neutral position of the knee and hip joints, and anatomically and kinesiologically justified in normal subjects. Moreover, CEA is a potential reference axis for the insertion of the femoral component in THA.展开更多
In most cases of arthritic varus knees, stepwise osteophytes removal and medial soft tissue release could achieve satisfactory soft tissue balance during total knee arthroplasty. However, in some severe cases, convent...In most cases of arthritic varus knees, stepwise osteophytes removal and medial soft tissue release could achieve satisfactory soft tissue balance during total knee arthroplasty. However, in some severe cases, conventional balancing techniques are not enough, necessitating other procedures like epicondylar osteotomy. To the best of our knowledge, no published article has reported the application of lateral epicondylar osteotomy in a severe varus knee. Here we reported a case of successful correction of a severe varus knee following lateral epicondylar osteotomy, and described its underlying rationale.展开更多
An abnormality of femoral anteversion (FA) is often recognized in patients with osteoarthritis of the hip joint (hip OA). And it is considered that rotation abnormality in the knee and the lower leg occurs as compensa...An abnormality of femoral anteversion (FA) is often recognized in patients with osteoarthritis of the hip joint (hip OA). And it is considered that rotation abnormality in the knee and the lower leg occurs as compensation, in cases of FA abnormality. The purpose of this study was to assess the magnitude and variability of FA and femoral condyle rotation (FCR) in order to identify the association between FA and FCR in female patients with hip OA who require total hip arthroplasty. A total of 174 hips from 174 hip OA patients undergoing THA were included in this study. All patients were Asian women (average age: 71.1 years). An equilateral correlation was accepted in FA and FCR. It was thought that FA abnormality might be accompanied by morphological rotation abnormalities of the knee joint. Caution is needed in considering femoral anteversion using the posterior condylar line. We must consider FA in patients undergoing THA after having considered the whole leg rotation.展开更多
文摘Background: Several researchers consider the clinical epicondylar axis (CEA) as the functional flexion-extension axis of the knee. The anterior pelvic plane (APP) is commonly used as an anatomical reference plane of the pelvis. However, no study has investigated the relationship of the APP with the CEA and PCA. In this study, we aimed to investigate the relationship of the APP with the CEA and posterior condylar axis (PCA) in the standing and supine positions. Methods: We recruited 77 healthy Japanese subjects for this study, and carried out measurements using the Hip CAS?system, a 3D system used for the assessment of lower extremity alignment. Results: The mean femoral neck anteversion was 16.33°. There was an approximate discrepancy of 6° between the male and the female in anatomy (15.73° and 21.15° in the male and female subjects, respectively). The mean condylar twist angle (CTA) was 6.86° and the mean APP-PCA value in the standing position was ﹣6.88°. The mean APP-CEA value in the standing position was 0.02°, and the discrepancy between males and females was only 0.21° (0.09° and ﹣0.13° for the male and female subjects, respectively). This meant that Xp axis of APP and CEA were almost parallel. On the other hand, the mean APP-CEA value in the supine position was 7.07° (male subjects = 9.48°;female subjects = 5.62°). Here, the CEA was approximately parallel to the horizontal axis of the APP, which was compatible with the neutral position of the knee and hip joint, and anatomically and kinesiologically justified in normal subjects. Conclusion: CEA was approximately parallel to the horizontal axis of the APP. These results are compatible with regard to the neutral position of the knee and hip joints, and anatomically and kinesiologically justified in normal subjects. Moreover, CEA is a potential reference axis for the insertion of the femoral component in THA.
文摘In most cases of arthritic varus knees, stepwise osteophytes removal and medial soft tissue release could achieve satisfactory soft tissue balance during total knee arthroplasty. However, in some severe cases, conventional balancing techniques are not enough, necessitating other procedures like epicondylar osteotomy. To the best of our knowledge, no published article has reported the application of lateral epicondylar osteotomy in a severe varus knee. Here we reported a case of successful correction of a severe varus knee following lateral epicondylar osteotomy, and described its underlying rationale.
文摘An abnormality of femoral anteversion (FA) is often recognized in patients with osteoarthritis of the hip joint (hip OA). And it is considered that rotation abnormality in the knee and the lower leg occurs as compensation, in cases of FA abnormality. The purpose of this study was to assess the magnitude and variability of FA and femoral condyle rotation (FCR) in order to identify the association between FA and FCR in female patients with hip OA who require total hip arthroplasty. A total of 174 hips from 174 hip OA patients undergoing THA were included in this study. All patients were Asian women (average age: 71.1 years). An equilateral correlation was accepted in FA and FCR. It was thought that FA abnormality might be accompanied by morphological rotation abnormalities of the knee joint. Caution is needed in considering femoral anteversion using the posterior condylar line. We must consider FA in patients undergoing THA after having considered the whole leg rotation.
