Published online May 18, 2017. doi: 10.5312/wjo.v8.i5.431
Peer-review started: November 10, 2016
First decision: February 15, 2017
Revised: March 4, 2017
Accepted: March 16, 2017
Article in press: March 17, 2017
Published online: May 18, 2017
To review and study the effect of lengthening along the anatomical axis of long bones and its relation to the mechanical axis deviation.
We try in this review to calculate and discuss the exact clinical impact of lengthening along the anatomical axis of the femur on affecting the limb alignment. Also we used a trigonometric formula to predict the change of the femoral distal anatomical mechanical angle (AMA) after lengthening along the anatomical axis.
Lengthening along the anatomical axis of the femur by 10% of its original length results in reduction in the distal femoral AMA by 0.57 degrees. There is no objective experimental scientific data to prove that the Mechanical axis is passing via the center of the hip to the center of the knee. There is wide variation in normal anatomical axis for different populations. In deformity correction, surgeons try to reproduce the normal usual bone shape to regain normal function, which is mainly anatomical axis.
Lengthening of the femur along its anatomical axis results in mild reduction of the distal femoral AMA. This may partially compensate for the expected mechanical axis lateralisation and hence justify its minimal clinical impact.
Core tip: In deformity correction the aim is to reproduce the normal anatomical shape of the bone to regain normal function. There is no experimental data to prove the passage of the imaginary mechanical axis and load distribution of the body via the center of the hip to the center of the knee. Lengthening along anatomical axis of the bone is expected to cause minimal or no clinical effect on mechanical axis and load distribution on joints.