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Abstract Objective To compare and analyse the alignment changes in knee with osteoarthritis and its correlation with imaging and clinical Clinical manifestations. Methods The data of imaging and clinical manifestations of patients who underwent Total Knee Arthroplasty(TKA) were obtained with the help of Picture Archiving and Communication Systems(PACS).The joint space width and angles were measured using goniometers provided by PACS system with the help of a real protractor.Using the mathematical model to calculate the low limb's bone hip-knee-ankle angle(HKA angle) which exclueded the cartilage factors.Patients were divided into two groups according to the bone-HKA angle.The age，Kellgren-Lawrence(KL) grade，course of disease，hip and knee ankle angle and BMI were retrospectively analyzed.Results A total of 30 patients(36 knee) were finally enrolled in the study.The mean age was 64.33，history of osteoarthritis was 11.83 years，BMI was 27.22 kg／m2，and VAS score was 81.67 in patients with bone-HKA angle ≤174.4 degrees.The mean age was 59.33，history of osteoarthritis was 5.67 years，BMI was 27.84 kg／m2，and VAS score was 70.83 in patients with bone-HKA angle >174.4 degrees.The of age，course of knee osteoarthritis and medial/lateral joint space width between two groups were statistically different，while there is no significance of the rest analytic items between the two groups.Bone-HKA angle was significantly correlated with age，the time of OA，and the medial and lateral joint space wide(P＜0.05).The correlation of joint space wide difference，transverse diameter of tibial plateau with Bone-HKA was not obvious(P＞0.05).Conclusion Biomechanical changes and non-uniform settlement existed as independent factors in the development and progression of knee osteoarthritis.The reduction of Bone-HKA angle caused by non-uniform settlement is a primary factor in OA.Articular cartilage degeneration and reduction of Bone-HKA aggravate the clinical symptoms of osteoarthritis patients.
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