Hip-Knee-Ankle (HKA) angle modification during gait in healthy subjects

Julien Clément; William Blakeney; Nicola Hagemeister; François Desmeules; Neila Mezghani; Véronique Lowry; Pascal-André Vendittoli

doi:10.1016/j.gaitpost.2019.05.025

Hip-Knee-Ankle (HKA) angle modification during gait in healthy subjects

Julien Clément, William Blakeney, Nicola Hagemeister, François Desmeules, Neila Mezghani, Véronique Lowry, Pascal-André Vendittoli

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

BACKGROUND: Achieving a neutral static Hip-Knee-Ankle angle (sHKA) measured on radiographs has been considered a factor of success for total knee arthroplasty (TKA). However, recent studies have shown that sHKA seems to have no effect on TKA survivorship. sHKA is not representative of the dynamic loading occurring during gait, unlike the dynamic HKA (dHKA).

RESEARCH QUESTION: The primary objective was to see if the sHKA is predictive of the dynamic HKA (dHKA). A secondary objective was to document to what degree the dHKA changes during gait.

METHODS: We analysed 3D knee kinematics during gait of a cohort of 90 healthy individuals with the KneeKG™ system. dHKA was calculated and compared with sHKA. Knees were considered "Stable" if the dHKA remained in valgus or varus for greater than 95% of the corresponding phase, and "Changer" otherwise. Patient characteristics of the Stable and Changer knees were compared to find associated factors.

RESULTS: Absolute variation of dHKA during gait was 10.9 ± 5.3° for the whole cohort. The variation was less for the varus knees (10.3 ± 4.8°), than for the valgus knees (12.8 ± 6.1°, p = 0.008). We found low to moderate correlations (r = 0.266 to 0.553, p < 0.001) between sHKA and dHKA values for varus knees and no significant correlation for valgus knees. Twenty two percent (36/165) of the knees were considered Changers. The proportion of knees that were Changers was 15% of the varus versus 39% of the valgus (p < 0.001).

SIGNIFICANCE: Lower limb radiographic measures of coronal alignment have limited value for predicting dynamic measures of alignment during gait.

Original language	English
Pages (from-to)	62-68
Number of pages	7
Journal	Gait and Posture
Volume	72
DOIs	https://doi.org/10.1016/j.gaitpost.2019.05.025
Publication status	Published - Jul 2019
Externally published	Yes

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10.1016/j.gaitpost.2019.05.025

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@article{517cb641a16343a6b11dc9bb45184818,

title = "Hip-Knee-Ankle (HKA) angle modification during gait in healthy subjects",

abstract = "BACKGROUND: Achieving a neutral static Hip-Knee-Ankle angle (sHKA) measured on radiographs has been considered a factor of success for total knee arthroplasty (TKA). However, recent studies have shown that sHKA seems to have no effect on TKA survivorship. sHKA is not representative of the dynamic loading occurring during gait, unlike the dynamic HKA (dHKA).RESEARCH QUESTION: The primary objective was to see if the sHKA is predictive of the dynamic HKA (dHKA). A secondary objective was to document to what degree the dHKA changes during gait.METHODS: We analysed 3D knee kinematics during gait of a cohort of 90 healthy individuals with the KneeKG{\texttrademark} system. dHKA was calculated and compared with sHKA. Knees were considered {"}Stable{"} if the dHKA remained in valgus or varus for greater than 95% of the corresponding phase, and {"}Changer{"} otherwise. Patient characteristics of the Stable and Changer knees were compared to find associated factors.RESULTS: Absolute variation of dHKA during gait was 10.9 ± 5.3° for the whole cohort. The variation was less for the varus knees (10.3 ± 4.8°), than for the valgus knees (12.8 ± 6.1°, p = 0.008). We found low to moderate correlations (r = 0.266 to 0.553, p < 0.001) between sHKA and dHKA values for varus knees and no significant correlation for valgus knees. Twenty two percent (36/165) of the knees were considered Changers. The proportion of knees that were Changers was 15% of the varus versus 39% of the valgus (p < 0.001).SIGNIFICANCE: Lower limb radiographic measures of coronal alignment have limited value for predicting dynamic measures of alignment during gait.",

keywords = "Adolescent, Adult, Aged, Ankle/physiology, Biomechanical Phenomena, Cohort Studies, Female, Gait, Healthy Volunteers, Hip/physiology, Humans, Knee/physiology, Male, Middle Aged, Young Adult",

author = "Julien Cl{\'e}ment and William Blakeney and Nicola Hagemeister and Fran{\c c}ois Desmeules and Neila Mezghani and V{\'e}ronique Lowry and Pascal-Andr{\'e} Vendittoli",

year = "2019",

month = jul,

doi = "10.1016/j.gaitpost.2019.05.025",

language = "English",

volume = "72",

pages = "62--68",

journal = "Gait & Posture",

issn = "0966-6362",

publisher = "Elsevier",

}

TY - JOUR

T1 - Hip-Knee-Ankle (HKA) angle modification during gait in healthy subjects

AU - Clément, Julien

AU - Blakeney, William

AU - Hagemeister, Nicola

AU - Desmeules, François

AU - Mezghani, Neila

AU - Lowry, Véronique

AU - Vendittoli, Pascal-André

PY - 2019/7

Y1 - 2019/7

N2 - BACKGROUND: Achieving a neutral static Hip-Knee-Ankle angle (sHKA) measured on radiographs has been considered a factor of success for total knee arthroplasty (TKA). However, recent studies have shown that sHKA seems to have no effect on TKA survivorship. sHKA is not representative of the dynamic loading occurring during gait, unlike the dynamic HKA (dHKA).RESEARCH QUESTION: The primary objective was to see if the sHKA is predictive of the dynamic HKA (dHKA). A secondary objective was to document to what degree the dHKA changes during gait.METHODS: We analysed 3D knee kinematics during gait of a cohort of 90 healthy individuals with the KneeKG™ system. dHKA was calculated and compared with sHKA. Knees were considered "Stable" if the dHKA remained in valgus or varus for greater than 95% of the corresponding phase, and "Changer" otherwise. Patient characteristics of the Stable and Changer knees were compared to find associated factors.RESULTS: Absolute variation of dHKA during gait was 10.9 ± 5.3° for the whole cohort. The variation was less for the varus knees (10.3 ± 4.8°), than for the valgus knees (12.8 ± 6.1°, p = 0.008). We found low to moderate correlations (r = 0.266 to 0.553, p < 0.001) between sHKA and dHKA values for varus knees and no significant correlation for valgus knees. Twenty two percent (36/165) of the knees were considered Changers. The proportion of knees that were Changers was 15% of the varus versus 39% of the valgus (p < 0.001).SIGNIFICANCE: Lower limb radiographic measures of coronal alignment have limited value for predicting dynamic measures of alignment during gait.

AB - BACKGROUND: Achieving a neutral static Hip-Knee-Ankle angle (sHKA) measured on radiographs has been considered a factor of success for total knee arthroplasty (TKA). However, recent studies have shown that sHKA seems to have no effect on TKA survivorship. sHKA is not representative of the dynamic loading occurring during gait, unlike the dynamic HKA (dHKA).RESEARCH QUESTION: The primary objective was to see if the sHKA is predictive of the dynamic HKA (dHKA). A secondary objective was to document to what degree the dHKA changes during gait.METHODS: We analysed 3D knee kinematics during gait of a cohort of 90 healthy individuals with the KneeKG™ system. dHKA was calculated and compared with sHKA. Knees were considered "Stable" if the dHKA remained in valgus or varus for greater than 95% of the corresponding phase, and "Changer" otherwise. Patient characteristics of the Stable and Changer knees were compared to find associated factors.RESULTS: Absolute variation of dHKA during gait was 10.9 ± 5.3° for the whole cohort. The variation was less for the varus knees (10.3 ± 4.8°), than for the valgus knees (12.8 ± 6.1°, p = 0.008). We found low to moderate correlations (r = 0.266 to 0.553, p < 0.001) between sHKA and dHKA values for varus knees and no significant correlation for valgus knees. Twenty two percent (36/165) of the knees were considered Changers. The proportion of knees that were Changers was 15% of the varus versus 39% of the valgus (p < 0.001).SIGNIFICANCE: Lower limb radiographic measures of coronal alignment have limited value for predicting dynamic measures of alignment during gait.

KW - Adolescent

KW - Adult

KW - Aged

KW - Ankle/physiology

KW - Biomechanical Phenomena

KW - Cohort Studies

KW - Female

KW - Gait

KW - Healthy Volunteers

KW - Hip/physiology

KW - Humans

KW - Knee/physiology

KW - Male

KW - Middle Aged

KW - Young Adult

U2 - 10.1016/j.gaitpost.2019.05.025

DO - 10.1016/j.gaitpost.2019.05.025

M3 - Article

C2 - 31151089

VL - 72

SP - 62

EP - 68

JO - Gait & Posture

JF - Gait & Posture

SN - 0966-6362

ER -

Hip-Knee-Ankle (HKA) angle modification during gait in healthy subjects

Abstract

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