The anteroposterior axis of the tibia is adjusted to approximately a right angle to the anterior pelvic plane in the standing position in patients with hip dysplasia similar to normal subjects: a cross-sectional study

Abstract

BackgroundWe previously described that the anteroposterior (AP) axis of the tibia is approximately perpendicular to the transverse axis of the anterior pelvic plane (APP) in the standing position in healthy subjects. The purpose of this study was to investigate the rotational alignment between the APP and clinical epicondylar axis and the AP axis of the tibia relative to pelvic coordination in the standing position in normal subjects and in women with developmental dysplasia of the hip (DDH) to aid decision making for surgeons in the alignment of implants in total hip or knee arthroplasty.MethodsThis study included 77 Japanese women. Twenty-nine in the DDH group underwent curved periacetabular osteotomy; 48 women without lumbago and knee pain were included in the normal group. Femoral neck anteversion (FNA), condylar twist angle, and knee rotation angle were measured in femoral coordination. The angle between the femoral neck axis and clinical epicondylar axis (CEA) was measured, the transverse axis of the APP was also measured, and the angle between the AP axis of the tibia and transverse axis of the APP was calculated.ResultsThere was a moderate negative correlation between FNA and CEA relative to the APP. This finding indicated a trend towards greater FNA leading to more internal rotation. Knee rotation angle (KRA) relative to the APP was 1.65° ± 5.58° in the normal group and − 2.65° ± 7.57° in the DDH group. This finding indicated that the tibia AP axis was approximately perpendicular to the APP in the standing position both in the normal and DDH groups.ConclusionWe found that the tibia AP axis was at approximately a right angle to the transverse axis of the APP in the standing position in both the normal and DDH groups, while the KRA was different in the normal and DDH groups. These findings may prove helpful for positional alignment investigations needed for implantation in total hip or knee arthroplasty and gait analysis.

Tibiofemoral rotation is related to differences in the lateral femoral condyle configuration in both normal subjects and women with hip dysplasia: a three-dimensional analysis

“…Several investigations described the morphological features with regard to the acetabulum and the proximal femur in patients with DDH to investigate the etiology and/or prevention of osteoarthritis of the hip [3–5]. However, morphological deformities in DDH not only appear in the hip joint but also in the knee joint, such as “coxitis knee” [6, 7]. However, few reports have investigated the knee joints and their morphology in DDH patients.…”

“…Moreover, the knee rotation angle (KRA) has previously been shown to be significantly larger in patients with DDH than in normal healthy subjects, and there was no significant correlation between femoral neck anteversion and KRA when using the three-dimensional (3D) method [7]. Li et al [6] described that the width of the femoral condyles was smaller and observed greater asymmetry at the medial and lateral condyles in DDH patients than in normal hips.…”

Coordinate value of the femoral head center estimated using those of the tip of the greater trochanter and lesser trochanter

“…Data on the subjects were described regarding the spatial alignment of the femur and tibia from a previous study [14][15][16] and were used with written permission. The participants had no back or knee symptoms.…”

“…No abnormalities were observed on the plain radiographs of the hip, knee, or spine. CT was performed on all subjects to reconstruct the 3D bone models of the pelvis and femur, as described previously [14][15][16] . A multislice CT scanner with a 64-row detector (Aquilion64™; Toshiba Medical Systems, Otawara, Tochigi, Japan) acquired approximately 500 slices (slice thickness, 1.25 mm) from each participant.…”

Total Hip Arthroplasty for Low-Grade Developmental Hip Dysplasia Changes the Ipsilateral Knee Alignment on the Axial and Coronal Planes

“…The tibial rotational alignment: the knee rotation angle (KRA: the angle between the perpendicular line of the trans-epicondylar axis and the Akagi's line) and the pelvis-tibia angle (PTA: the angle between the tangent to the posterior ischial spine and the Akagi's line) [5,24].…”