Factors contributing to inherent varus alignment of lower limb in normal Asian adults: Role of tibial plateau inclination |
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| Institution: | 1. Department of Orthopaedic Surgery, Breach Candy Hospital, Mumbai, India;2. Department of Orthopaedic Surgery, Inje University Ilsanpaik Hospital, Ilsan, Korea;1. University of Ljubljana, Faculty of Health Sciences, Department of Physiotherapy, Zdravstvena pot 5, 1000 Ljubljana, Slovenia;2. University of Ljubljana, Faculty of Health Sciences, Slovenia;3. University of Ljubljana, Medical Faculty, Institute for Biostatistics and Medical Informatics, Slovenia;4. University of Ljubljana, Faculty of Health Sciences, Biomechanics Laboratory, Slovenia;5. Arthron, Institute for Joint and Sports Injuries, Slovenia;1. Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Germany;2. Dr. h.c. Robert Mathys Foundation, Bettlach, Switzerland;3. Mathys Ltd, Bettlach, Switzerland;4. Department of Orthopedic Surgery, Inselspital, Bern University Hospital, Switzerland;5. Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Switzerland;6. Sonnenhof Orthopaedic Clinic, Swiss Leading Hospitals, Berne, Switzerland;1. Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do 626-770, Republic of Korea;2. Joint Reconstruction Center, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea;1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;2. Department of Orthopaedic Surgery, Kobe Kaisei Hospital, Kobe, Japan |
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| Abstract: | PurposeThis prospective study aimed to evaluate radiographically, mechanical or hip–knee–ankle (HKA) axis in healthy, asymptomatic, Asian (Indian and Korean) adults between 20 and 40 years of age to determine the incidence of inherent varus (mechanical limb alignment of > 3° varus) and the factors influencing it.MethodsThree hundred and eighty-eight lower limbs were evaluated using full length, standing hip-to-ankle radiographs in 198 healthy, asymptomatic, Asian (Indian and Korean) adults between 20 and 40 years of age to assess the hip–knee–ankle (HKA) angle, medial proximal tibial angle (MPTA), femoral bowing and femoral neck–shaft angle to determine the incidence of inherent varus (mechanical limb alignment of > 3° varus) and the factors influencing it.ResultsOverall, the mean HKA angle was 177.6° ± 2.6° with 34.5% of limbs in inherent varus (mean HKA angle 174.9° ± 1.8°). The incidence of inherent varus was significantly higher (p = 0.01) in males (40%) compared to females (28%) but similar among Indian (34%) and Korean subjects (35%). The hip–knee–ankle (HKA) angle showed significant positive correlation (r = 0.82, p < 0.001) with only the medial proximal tibial angle (MPTA).ConclusionsInherent varus alignment of the lower limb is fairly common among asymptomatic, Asian adults. These results raise several pertinent questions regarding the role of inherent varus in the aetiopathogenesis of knee osteoarthritis and in lower limb realignment procedures. |
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