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Objectives <p>The effect of proximal femoral malalignment on coronal knee alignment remains controversial, with discordance between mechanical postulates and clinical observations. This study aimed to evaluate whether proximal femoral varisation in children results in alteration of coronal knee alignment and to compare alignment changes between supratrochanteric and infratrochanteric locations of varus deformity.</p> Methods <p>In this retrospective study, 26 children with proximal femoral varus deformity were reviewed. Fifteen had supratrochanteric varisation secondary to various pathologies, while 11 had infratrochanteric varisation following surgical treatment for Perthes disease. At final follow-up, affected and contralateral normal limbs were compared using standing scanograms. Radiological parameters assessed included neck–shaft angle (NSA), mechanical axis deviation (MAD), femorotibial angle (FTA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), lateral distal tibial angle (LDTA), and percentage mechanical axis deviation. Subgroup and intergroup analyses were performed to evaluate the influence of the level of varisation on knee alignment.</p> Results <p>The mean age at final follow-up was 10.8 years, with a mean follow-up duration of 5 years. Although a mild valgus tendency was observed in LDFA on the affected side, the difference was not statistically significant. In subgroup analysis, the infratrochanteric group demonstrated a significant difference in FTA, reflecting alteration of the anatomical axis. However, overall coronal knee alignment parameters, including mechanical axis deviation, were comparable between affected and normal limbs. No significant differences were observed between supratrochanteric and infratrochanteric groups with respect to knee alignment.</p> Conclusions <p>Proximal femoral varus deformity with a mean neck–shaft angle alteration of less than 30° does not result in significant coronal knee malalignment in skeletally immature patients. This observation holds true irrespective of whether the varisation is supratrochanteric or infratrochanteric in location.</p>

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Influence of Proximal Femoral Varus Deformity on Coronal Knee Alignment

  • 期刊论文

  • 发表日期：

    2026年6月14日

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  • Anil Agarwal,
  • Md Zafar Iqbal,
  • K. S. Ankitha,
  • Mannan Gupta,
  • Sankalp Singh,
  • Shivank Khurana

摘要

Objectives

The effect of proximal femoral malalignment on coronal knee alignment remains controversial, with discordance between mechanical postulates and clinical observations. This study aimed to evaluate whether proximal femoral varisation in children results in alteration of coronal knee alignment and to compare alignment changes between supratrochanteric and infratrochanteric locations of varus deformity.

Methods

In this retrospective study, 26 children with proximal femoral varus deformity were reviewed. Fifteen had supratrochanteric varisation secondary to various pathologies, while 11 had infratrochanteric varisation following surgical treatment for Perthes disease. At final follow-up, affected and contralateral normal limbs were compared using standing scanograms. Radiological parameters assessed included neck–shaft angle (NSA), mechanical axis deviation (MAD), femorotibial angle (FTA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), lateral distal tibial angle (LDTA), and percentage mechanical axis deviation. Subgroup and intergroup analyses were performed to evaluate the influence of the level of varisation on knee alignment.

Results

The mean age at final follow-up was 10.8 years, with a mean follow-up duration of 5 years. Although a mild valgus tendency was observed in LDFA on the affected side, the difference was not statistically significant. In subgroup analysis, the infratrochanteric group demonstrated a significant difference in FTA, reflecting alteration of the anatomical axis. However, overall coronal knee alignment parameters, including mechanical axis deviation, were comparable between affected and normal limbs. No significant differences were observed between supratrochanteric and infratrochanteric groups with respect to knee alignment.

Conclusions

Proximal femoral varus deformity with a mean neck–shaft angle alteration of less than 30° does not result in significant coronal knee malalignment in skeletally immature patients. This observation holds true irrespective of whether the varisation is supratrochanteric or infratrochanteric in location.