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Variability of functional knee phenotype for coronal alignment in advanced varus knee osteoarthritis in the Japanese population

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

New concept of functional knee phenotypes in Caucasians demonstrated the variability of coronal alignment in knee osteoarthritis (OA), but it remains unclear in Japanese. This study aims to analyze the knee phenotype in advanced varus knee OA for Japanese. In addition, the ethnical difference is discussed.

Methods

This study analyzed 879 knees involving 186 males (74 years) and 693 females (74 years). The knee phenotypes were assessed by the definition in Hirschmann’s group. The hip–knee–ankle angle (HKA), femoral mechanical angle (FMA) and tibial mechanical angle (TMA) were assessed in CT data according to the coordinate system. The neutral angle was 180° in HKA, 93° in FMA and 87° in TMA. The smaller angle means larger varus angles.

Results

The average angle (males, females) of the HKA (170.9 ± 4.3°, 169.4 ± 5.0°), FMA (91.5 ± 2.7°, 90.6 ± 3.0°), and TMA (82.4 ± 3.6°, 82.7 ± 3.7°) demonstrated varus angles with the sex difference (HKA, p < 0.001; FMA, p = 0.001). The phenotypes were 73 types in males and 150 types in females with a mild correlation between the HKA and the FMA or TMA. In 61.3% of males and 52.2% of females, the TMA was greater than the FMA, while the FMA was greater in 16.7% of males and 23.1% of females.

Conclusion

There were many functional knee phenotypes with sex differences for advanced varus knee OA in Japanese, showing ethnical differences of larger varus angles compared to those for Caucasians in the previous report.

Level of evidence

IV.

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Data availability

The datasets generated and/or analyzed during the current study are not publicly available.

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Acknowledgements

The authors would like to thank all members of Niigata Knee Group: Drs. Murayama T, Fujita Y, Hokari S, Higuchi K, Takagi S, Sakazume Y, Katsumi R, Wakui J, Suda Y, Shimagaki S, Hijikata H, Maeda K, Omori G and Yamamoto N.

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Authors and Affiliations

  1. Division of Orthopedic Surgery, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori Chuo-ku, Niigata City, 951-8510, Japan

    Wang Huan, Tomoharu Mochizuki, Osamu Tanifuji & Hiroyuki Kawashima

  2. Department of Orthopedic Surgery, The First Affiliated Hospital, Harbin Medical University, Harbin, China

    Wang Huan

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  1. Wang Huan
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  2. Tomoharu Mochizuki
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Correspondence to Tomoharu Mochizuki.

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Huan, W., Mochizuki, T., Tanifuji, O. et al. Variability of functional knee phenotype for coronal alignment in advanced varus knee osteoarthritis in the Japanese population. Knee Surg Sports Traumatol Arthrosc 31, 1451–1461 (2023). https://doi.org/10.1007/s00167-022-07248-0

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