Journal of Korean Foot and Ankle Society

Table. 2.

Table. 2.

The Results of the Studies on the Effects of Increase in Femoral Anteversion Angle on Joints Loading, Kinetic and Kinematic Parameters

Reference Method Result
Radler et al., 201011) Patients: 26 subjects with toe-in gait
Intervention: None
Comparison: ROM of pelvis and hip joint, and their correlation with FA
Mean femoral anteversion was 28 degrees, mean tibia torsion was 28 degrees (external rotation).
High correlation exists between pelvis ROM and femoral anteversion which reports the role of pelvis to be involved as a compensatory mechanism. But there was a weak correlation between FA and hip rotation.
Bruderer-Hofstette et al., 201512) Patients: 18 subjects with toe-in gait (10.5~17.5 years) and 17 normal subjects (10.6~17.3 years)
Intervention: None
Comparison: Kinematic and kinetic parameters while walking. Principle component analysis (PCA) was performed using MATLAB.
The mean of anteversion angle based on CT-scan was 38.9 degrees. The patients had more anterior pelvic tilt than control, patients had more hip flexion angle and less hip extension angle compared to control.
Foot external rotation in patients is less than control group. Anteversion is not just a cosmetic problem as modification in kinematic and kinetic may be associated with future physical problems or even osteoarthritis.
Nyland et al., 200413) Patients: 18 normal female
Intervention: Resistance belt (push up and out against resistance)
Comparison: EMG was recorded from tensor fascia lata, gluteus medius and maximus and vastus medialis.
For the subjects with increased anteversion angle (medial hip rotation >42 degrees) there was a 34% decrease in mean peak gluteus medius EMG amplitude and 27% decrease in mean peak of vastus medialis.
It seems that increase in femoral anteversion angle is associated with reduced dynamic control of hip and patellofemoral joints in frontal and transverse planes.
Naseri el al, 202024) Patients: 7 diplegic CP (aged between 8~12 years with aberrant femoral geometry [FA 23~56 degrees], with neck shaft angle [NSA] between 133 and 157 degrees)
Intervention: None
Comparison: joint angle, joint moments normalized and potential joint angular acceleration
All children walked with increased hip and knee flexion angle throughout the gait cycle, indicating crouch gait. This study supported the effects of proximal femoral deformity and CP gait characteristics on control of hip, knee joint kinematics during CP-gait. Proximal deformity mainly affects sagittal plane muscle control. The compensatory mechanism in pathologic gait may influence joint loading.
Cimolin et al., 201025) Patients: 23 CP diplegic children (5~13 years, mean 9.27 years), and control group = 15 healthy subjects (5~16 years)
Intervention: None
Comparison: Gait analysis and EMG of leg muscles
CP subjects were divided into groups: Those with increase in femoral anteversion without Rectus Femoris spasticity and those with normal anteversion with Rectus Femoris spasticity
Those with increase in femoral anteversion exhibited a reduced value of KMSW parameter with excessive hip internal rotation. Spasticity of Rectus Femoris reduced peak of knee flexion in swing with delay in its timing with hip rotation closed to normative data.

ROM: range of motion, FA: femural anteversion, CP: cerebral palsy, EMG: electromyograph, KMSW: knee moment slow walking.

J Korean Foot Ankle Soc 2023;27:17-23
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