1
|
Sun JY, Ma HY, Shen JM, Du YQ, Dong Y, Zhang YC, Zhou YG, Wang Y. Factors influencing knee valgus alignment in Crowe type IV hip dysplasia after total hip arthroplasty. J Orthop Traumatol 2021; 22:41. [PMID: 34655357 PMCID: PMC8520551 DOI: 10.1186/s10195-021-00601-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 09/26/2021] [Indexed: 11/20/2022] Open
Abstract
Background Valgus deformity of the knee remains a complaint after total hip arthroplasty (THA) among some patients with Crowe type IV hip dysplasia. We aimed to identify the knee alignment in these patients before and after surgery, and to explore the factors contributing to postoperative knee valgus alignment. Materials and methods We retrospectively reviewed a series of Crowe type IV patients who received THA between February 2010 and May 2019 in our hospital. The patients’ medical data were collected from the hospital information system. On both preoperative and postoperative full limb length standing radiographs, the following parameters were measured: hip–knee–ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle, anatomical tibiofemoral angle, anatomical lateral distal femoral angle, femoral neck-shaft angle, pelvic obliquity, limb length, height and lateral distance of hip center, and femoral offset. Univariate and multivariate binary logistic regression were used to identify the factors influencing postoperative knee valgus alignment. Results A total of 64 Crowe type IV patients (87 hips) were included in the study. Overall, HKA improved from 176.54 ± 3.52° preoperatively to 179.45 ± 4.31° at the last follow-up. Those hips were subdivided into non-valgus group (≥ 177.0°, n = 65) and valgus group (< 177.0°, n = 22) according to postoperative HKA. Only postoperative mLDFA was a significant factor in the multivariate regression model. Conclusions The postoperative mLDFA is a major factor related to knee valgus alignment after THA, which combines the preoperative anatomy and surgical reconstruction. Other factors previously published were found to have no significance. Level of evidence III.
Collapse
Affiliation(s)
- Jing-Yang Sun
- Medical School of Chinese PLA, Beijing, 100853, China.,Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Hai-Yang Ma
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Jun-Min Shen
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Yin-Qiao Du
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Yu Dong
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Yan-Chao Zhang
- Medical School of Chinese PLA, Beijing, 100853, China.,Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Yong-Gang Zhou
- Medical School of Chinese PLA, Beijing, 100853, China. .,Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Fuxing Road, Haidian District, Beijing, 100853, China.
| | - Yan Wang
- Medical School of Chinese PLA, Beijing, 100853, China. .,Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Fuxing Road, Haidian District, Beijing, 100853, China.
| |
Collapse
|