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Related Concept Videos

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The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
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Joints form during embryonic development in conjunction with the formation and growth of the associated bones. The embryonic tissue that gives rise to all bones, cartilage, and connective tissues of the body is called mesenchyme.
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Bones of the Lower Limb: Femur and Patella01:16

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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Bones of the Lower Limb: Tibia and Fibula01:10

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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...
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Updated: Aug 11, 2025

Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
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Limb alignment changes with knee flexion: A study based on CAS data.

Alvise Saracco1, Charles Rivière2, Gabriel R Bouchard2

  • 1Department of Hip & Knee Replacement Surgery - IRCCS San Raffaele Hospital, Milan, Italy; B.A.R.I. (Bordeaux Arthroplasty Research Institute), France.

The Knee
|February 3, 2023
PubMed
Summary
This summary is machine-generated.

Lower limb alignment in knee osteoarthritis (OA) patients varies significantly with knee flexion. Standing alignment is a poor predictor of alignment during flexion, suggesting current planning methods for knee surgery may be insufficient.

Keywords:
Computer-assisted surgeryKnee osteoarthritisLimb alignmentPersonalized arthroplasty

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Area of Science:

  • Orthopedics
  • Biomechanics
  • Medical Imaging

Background:

  • Evidence questions the predictive value of standing limb alignment for knee joint forces.
  • Osteoarthritis (OA) knee patients' lower limb alignment at various flexion angles requires further assessment.

Purpose of the Study:

  • To assess lower limb alignment in OA knee patients across different knee flexion angles.
  • To test the hypothesis that lower limb alignment during flexion does not differ significantly based on extension alignment (neutral, varus, valgus).

Main Methods:

  • 206 OA knee patients undergoing computer-assisted surgery (CAS) total knee prosthesis were analyzed.
  • Frontal limb alignment (HKA angle) was measured by CAS at extension, 90°, and maximal knee flexion.
  • Changes in HKA angle (delta value) between positions were calculated and compared.

Main Results:

  • Significant alignment variation was observed in 32% of OA patients (Δ HKA > 5°).
  • Knee flexion reduced varus/valgus deformities, with many progressing to neutral alignment at 90° flexion.
  • Neutral extended alignment was not maintained, with some progressing to varus/valgus at 90° flexion.

Conclusions:

  • Standing limb alignment is an unreliable predictor of alignment in knee flexion for OA patients.
  • Relying solely on traditional frontal alignment in extension for knee arthroplasty or osteotomy planning is likely inadequate.