Abstract
BackgroundWe assessed the morphological differences in the knee joint related to knee rotation angle in patients with hip dysplasia. These results may explain the anatomy of the knee in patients with hip dysplasia and aid in planning knee surgery.MethodsWe enrolled 73 women (146 legs, 35.6 ± 9.0 years) with bilateral hip dysplasia and 45 healthy women (90 legs, 49.0 ± 18.9 years) without lumbago, knee symptoms, or osteoarthritic findings of the knee or spine on plain radiographs. We examined the parameters affecting knee rotation angle, such as the condylar twist angle and femoral condyle measurements with a three-dimensional bone model using the correlation coefficients of each parameter.ResultsThe condylar twist angle and the length of the posterior part of the lateral femoral condyle were statistically positively correlated with knee rotation angle in both the normal (condylar twist angle: r = 0.286, p = 0.007, posterolateral: r = 0.429, p < 0.001) and developmental dysplasia of the hip groups (condylar twist angle: r = 0.230, p = 0.033, posterolateral: r = 0.272, p = 0.005). Knee rotation angle had no statistical correlation with femoral neck anteversion in the developmental dysplasia of the hip group (r = 0.094, p = 0.264), but had a statistical correlation with femoral neck anteversion in the normal group (r = 0.243, p = 0.039).ConclusionsKnee joint morphology is affected by hip dysplasia. We found that the length of the posterior part of the lateral femoral condyle was significantly positively correlated with knee rotation angle in both the normal and developmental dysplasia of the hip groups, and this finding indicates that a greater posterolateral dimension was associated with a greater knee rotation angle. These morphological knee joint differences in patients with hip dysplasia may help determine the alignment of prostheses in total knee arthroplasty.
Highlights
We assessed the morphological differences in the knee joint related to knee rotation angle in patients with hip dysplasia
Developmental dysplasia of the hip (DDH) is considered the most common etiology of secondary osteoarthritis of the hip [1], and notably, the incidence of DDH is higher in Asians [2]
Femoral neck anteversion (FNA), knee rotation angle (KRA), and PL were statistically larger in the DDH group; by contrast, clinical epicondylar axis (CEA) length, AM, AL, and APM were significantly smaller (Table 1)
Summary
We assessed the morphological differences in the knee joint related to knee rotation angle in patients with hip dysplasia. These results may explain the anatomy of the knee in patients with hip dysplasia and aid in planning knee surgery. 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 [3,4,5]. The 2D method is unable to evaluate malalignment spatially and geometrically between the femur and tibia, such as tibiofemoral rotation, which is considered to cause some lower extremity pathologies [10, 11]
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