Predicting the Alignment of Arthritic Knees Using the Arithmetic Hip-knee-ankle Angle Compared to Normal Contralateral Knees in the Asian Population
Background: The arithmetic hip-knee-ankle (aHKA) algorithm is recommended as a dependable method for forecasting the natural alignment of the lower limb in Western populations. However, its precision for Asian populations remains uncertain. Objectives: This study aimed to investigate the accuracy of...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-04-01
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| Series: | Formosan Journal of Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/fjmd.FJMD-D-24-00002 |
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| Summary: | Background:
The arithmetic hip-knee-ankle (aHKA) algorithm is recommended as a dependable method for forecasting the natural alignment of the lower limb in Western populations. However, its precision for Asian populations remains uncertain.
Objectives:
This study aimed to investigate the accuracy of the arithmetic hip-knee-ankle angle (aHKA) algorithm in determining the constitutional alignment of the lower limb in the Asian population following significant arthritis, which could be beneficial for kinematically aligned total knee arthroplasty (TKA) procedures.
Materials and Methods:
A paired radiological study compared the aHKA of a knee affected by osteoarthritis (aHKA-OA) with the mechanical hip-knee-ankle (mHKA) mHKA of the contralateral healthy knee (mHKA-N) in the same individual. The inclusion criteria encompassed patients who underwent knee arthroplasty at our hospital between December 2020 and July 2021 due to Grade 3 or 4 Kellgren–Lawrence tibiofemoral osteoarthritis (OA) in the arthritic knee requiring TKA and Grade 0 or 1 OA in the contralateral normal knee. The mean difference between the aHKA-OA and mHKA-N was compared and sex-based differences and the algorithm’s ability to predict constitutional alignment based on the degree of deformity were examined.
Results:
A total of 50 patients were included in the analysis. The results showed significant differences between the non-OA knee and the advanced OA knee regarding the medial proximal tibial angle, aHKA, and mHKA (P < 0.05). There was no significant difference when comparing aHKA-OA and mHKA-N (P = 0.853), and there was no sex-based difference when comparing aHKA-OA and mHKA-N (mean difference −1.47°; P = 0.568). However, knees with deformities >8° had a greater mean difference between aHKA-OA and mHKA-N (2.39°) than those with lesser deformities (1.48°; P = 0.013).
Conclusions:
aHKA algorithm is effective in predicting constitutional alignment after significant arthritis development in the Asian population. |
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| ISSN: | 2210-7940 2210-7959 |