Comprehensive Deformity Analysis
1. Mechanical Axis Deviation (MAD)
The MAD is the perpendicular distance from the center of the knee joint to the mechanical axis line connecting the center of the femoral head to the center of the ankle mortise. It dictates whether the overall limb alignment is neutral, varus, or valgus.
2. Mechanical Lateral Distal Femoral Angle (mLDFA)
The mLDFA evaluates the distal femur for deformity. It is the lateral angle formed between the mechanical axis of the femur and the distal femoral joint line. Values greater than 90° indicate a varus deformity of the femur, while values less than 85° indicate a valgus deformity.
3. Mechanical Medial Proximal Tibial Angle (MPTA)
The MPTA evaluates the proximal tibia. It is the medial angle formed between the mechanical axis of the tibia and the proximal tibial joint line. Values less than 85° signify a varus deformity of the tibia, while values greater than 90° signify a valgus deformity.
4. Joint Line Convergence Angle (JLCA)
The JLCA represents the angle between the distal femoral and proximal tibial articular surfaces. An abnormal JLCA indicates either a primary intra-articular deformity (e.g., cartilage loss) or collateral ligamentous laxity.
5. Center of Rotation of Angulation (CORA)
The CORA is mathematically derived by finding the intersection of the proximal and distal mechanical or anatomical axes. It represents the theoretical apex of the angular deformity magnitude. Surgical cuts (osteotomies) performed at this exact center, according to Hutaif's Rule 1, will yield pure angulation without requiring translation.