The ischiofemoral space of the hip is influenced by the fron
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The ischiofemoral distance (IFD), which is characterized as the distance between the ischial tuberosity and the lesser trochanter of the femur, is becoming more widely recognized as a non-articular cause of hip pain. The aim of this analysis was to see how realignment surgery around the knee affected the IFD. Valgisation osteotomy around the knee was thought to be linked to a reduction in the IFD.

A consecutive series of 154 patients undergoing frontal realignment procedures around the knee were included in this study. Long-leg standing radiographs were obtained before surgery and postoperatively. The IFD was measured between the ischium and the lesser trochanter at three different levels (proximal, middle and distal margins of the lesser trochanter parallel to the horizontal orientation of the pelvis) on standardized long-leg radiographs with the patient in upright standing position.

The knee alignment was determined by measuring the hip knee ankle angle, mechanical lateral distal femur angle and the medial mechanical proximal tibia angle. Linear regression was performed to determine the influence of the change of frontal knee alignment on the IFD.

Results:
--Linear regression showed a direct influence of the overall change in frontal knee alignment on the IFD of the hip, regardless of the site of the osteotomy (beta-0.4, confidence-interval - 0.5 to - 0.3).

--Valgisation osteotomy around the knee induced a significant reduction of the ipsilateral IFD, while varisation osteotomy induced a significant increase.

--The amount of ISD change was 0.4 mm per corresponding degree of change in frontal knee alignment.

In conclusion, all hip and knee surgeons should consider these results when preparing an osteotomy or arthroplasty operation. An ischiofemoral dispute in the hip may be resolved by correcting a knee malalignment. Both the hip and knee joints should have this term included in their medical workups.

Source: https://link.springer.com/article/10.1007/s00167-021-06589-6
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