How Do the Morphological Abnormalities of Femoral Head and Neck, Femoral Shaft and Femoral Condyle Affect the Occurrence and Development of Medial Knee Osteoarthritis

Objective At present, the main viewpoint is that tibial varus is the main reason of medial knee osteoarthritis (OA), and high tibial osteotomy (HTO) is also the main alignment correction method to correct medial knee OA. In contrast, the impact of the anatomical alignment of the femur on medial knee OA is often overlooked. We evaluated the increased risk for medial knee OA because a varus alignment could be attributed to the anatomical reasons that include hip anatomy, femoral shaft bowing (FSB) and femoral condylar dysplasia. Methods The present research adopted a cross‐sectional study method. We selected 62 patients with HTO in the Third Hospital of Hebei Medical University from June 2021 to March 2022 as the HTO group and 55 healthy volunteers as the control group. Femoral neck‐shaft angle (NSA), lateral FSB, mechanical lateral distal femoral angle (mLDFA) and hip‐knee‐ankle (HKA) was radiographically examined within the two groups. The femoral neck length and offset were also measured, and the ratio is represented by the ratio of the femoral neck length to off‐set (N/O). The 2‐tailed Student t‐test was used to compare the differences between groups when the data were in accordance with a normal distribution. Otherwise, the Mann–Whitney U tests was used to compare the differences between groups. Result Compared to the control group, the HTO group had a higher offset (p