Parameters of Lower Extremities Alignment View in Iranian Adult Population
Abstract
Normal axial alignment restoration in lower extremities is crucial for surgeons performing reconstructive surgeries. Since reference normal values of axial alignment are affected by age, sex, and ethical issues, we tried to scrutinize these parameters in Iranian adults and compare them with normal values in literatures. Through a cross-sectional design, standing axial alignment views of lower extremities were surveyed from 100 volunteers (50 males and 50 females) aged between 15-32 years. The lower extremities alignment variables were evaluated during two separate measurements. Total average values were used for comparison among genders. Tibiofemoral mechanical angle depicted mean varus of 1.5 degrees in an Iranian population that was significantly higher in male participants. The Mean angle between anatomical and mechanical axes of the femur was 5.7 ± 1.2º. The Knee joint was shown to be medially inclined 3.6 ± 1.7º in men comparing 2 ± 2º of women with a significant difference. Joint line congruence angle was medially inclined in all of the study participants with a mean of 1 ± 1.6º. To compare with anthropometric studies of western populations, Iranian participants had more varus lower limb alignment. It seemed mainly because of larger medially inclined knee joint (knee-joint obliquity). This finding along with more compensatory ankle valgus is similar to results of other Asian studies. Such racial variation should be considered in designing appropriate systems in reconstructive surgery.
Lotke PA, Ecker ML. Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg Am 1977;59(1):77-9.
Moreland JR, Basset LW, Hanker GJ. Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am 1987;69(5):745-9.
Hsu RW, Himeno S, Coventry MB, et al. Normal axial alignment of the lower Extremity and load bearing distribution at the knee. Clin Orthop 1990;255:215-27.
Insall JN. Surgical technique and Instrumentation in total knee arthroplasty: surgery of the knee. J N Insall RE Ed 1993;2:739-804.
Tamari K, Tinley P, Briffa K, et al. Ethnic-, Gender-, and Age-Related Differences in Femorotibial Angle, Femoral Antetorsion, and Tibiofibular Torsion. Clin Anat 2006;19(1):59-67.
Clarke HD, Hentz JG. Restoration of Femoral Anatomy in TKA With Unisex and Genderspecific Components. Clin Orthop Relat Res 2008;466(11):2711-6.
Vaidya SV, Ranawat CS, Aroojis A, et al. Anthropometric measurements to design total knee prostheses for the Indian population. J Arthroplasty 2000;15(1):79-85.
Tang WM, Zhu YH, Chiu KY. Axial alignment of the lower extremity in Chinese adults. J Bone Joint Surg Am 2000;82-A(11):1603-8.
Khattak M, Umer M, Davis ET, et al. Lower-limb alignment and posterior tibial slope in Pakistanis: a radiographic study. J Orthop Surg (Hong Kong) 2010;18(1):22-5.
Hungerford DS, Kenna RV, Krackow KA. The porouscoated anatomic total knee. Orthop Clin North Am 1982;13(1):103-22.
Paley D, Hergenberg JE, Tetswor K. Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin North Am 1994;25(3):425-65.
Fang Y, et al. The biomechanical study of rotating-arm self-locking intramedullary nails in comminuted femoral shaft fractures. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2006;23(5):1041-4.
Hoaglund FT, Yau AC, Wong WL. Osteoarthritis of the hip and other joints in southern Chinese in Hong Kong. Incidence and related factors. J Bone and Joint Surg Am 1973;55(3):545-57.
Danielsson L, Hernborg J. Morbidity and mortality of osteoarthritis of the knee (gonarthrosis) in Malmo, Sweden. Clin Orthop Relat Res 1970;69:224-6.
Sina Shahi A, Seyyed Hosseinzadeh HR, Kazemian GH, et al. Special Considerations in Asian Knee Arthroplasty, (Accessed in March 2014, 20, at http://www.intechopen.com/books/arthroplasty-update/ special- considerations-in-asian-knee-arthroplasty).
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Issue | Vol 53, No 5 (2015) | |
Section | Original Article(s) | |
Keywords | ||
Adult Ankle joint Iran Lower limb Knee |
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