ArticleInternational orthopaedics2017
Are advanced three-dimensional imaging studies always needed to measure the coronal knee alignment of the lower extremity?
Article in International orthopaedics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Highly variable coronal tibial and femoral alignment in osteoarthritic knees: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Pooled it
- Mechanical Axis Deviation Angle Versus Hip-Knee-Ankle Angle in Total Knee Arthroplasty: Correlation and Reliability.Indian journal of orthopaedics · 2025Article
- Rotational Projection Errors in Coronal Knee Alignment on Weight-Bearing Whole-Leg Radiographs: A 3D CT Reference Across CPAK Morphotypes.Bioengineering (Basel, Switzerland) · 2025Article
- The CPAK classification in three-dimensional measurements is consistent with those in two-dimensional measurements.Archives of orthopaedic and trauma surgery · 2025Article
- Excellent results of restricted kinematic alignment total knee arthroplasty at a minimum of 10 years of follow-up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Automated Measurements of Long Leg Radiographs in Pediatric Patients: A Pilot Study to Evaluate an Artificial Intelligence-Based Algorithm.Children (Basel, Switzerland) · 2024Article
- Influence of different standing positions on anatomical parameters of coronal whole-leg weight-bearing radiographs in preoperative planning for high tibial osteotomy.Journal of experimental orthopaedics · 2024Article
- Towards a better understanding of knee angular deformities: discrepancies between clinical examination and 2D/3D assessments.Archives of orthopaedic and trauma surgery · 2024Article
- Distribution of coronal plane alignment of the knee classification does not change as knee osteoarthritis progresses: a longitudinal study from the Toei study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Proximal external femoral torsion increases lateral femoral shaft bowing: a study based on 3D CT reconstruction models.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Primary osteoarthritic knees have more varus coronal alignment of the femur compared to young non-arthritic knees in a large cohort study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- The Effect of Position on Radiographic Angle Measurements of the Lower Extremities.BioMed research international · 2022Article
- Automated measurement of hip-knee-ankle angle on the unilateral lower limb X-rays using deep learning.Physical and engineering sciences in medicine · 2021Article
- The impact of limb loading and the measurement modality (2D versus 3D) on the measurement of the limb loading dependent lower extremity parameters.BMC musculoskeletal disorders · 2020Article
- Lateral femoral sliding osteotomy in total knee arthroplasty with valgus deformity greater than twenty degrees.International orthopaedics · 2019Article
- Citations, non-citations and visibility of International Orthopaedics in 2017.International orthopaedics · 2018Article
- O papel da estereorradiografia na avaliação das deformidades dos membros inferiores.Radiologia brasileiraReview
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5 authors.
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Abstract
backgroundCoronal malalignment of the lower extremity is closely related to the onset and progression of osteoarthritis. Restoring satisfactory alignment after tibial osteotomy improves the long-term success of this conservative surgery. The purpose of our study was to determine (1) if there is a difference between two-dimensional (2D) and 3D measurements of the hip-knee-ankle (HKA) angle between the mechanical axes of the femur and the tibia, (2) which parameter most affects 2D-3D HKA measurement, and (3) the percentage of patients who are at risk of error in HKA measurement.
methodsWe reviewed imaging studies of the consecutive patients referred to us for hip or knee pain between June and October 2013. Patients with previous pelvis or lower extremity surgery were excluded.
resultsIn 51 % (95/186) of lower extremities examined, the 3D method showed more valgus than the 2D method, and in 49 % (91/186), the 3D method showed more varus. In 12 % of extremities (23/186), the knee varus or valgus alignment was completely opposite in 3D images compared to 2D images. Having more than 7° of flexum/recurvatum alignment increased error in 2D HKA measurement by 5.7°. This was calculated to be 0.15° per 1° increase in femoral torsion and 0.05° per 1° increase in tibial torsion. Approximately 20 % of patients might be at risk of error in HKA angle measurement in 2D imaging studies.
conclusionsOrthopaedic surgeons should assess lower extremity alignment in standing position, with enough exposure of the extremity to find severe alignment or rotational deformities, and consider advanced 3D images of those patients who have them. Otherwise, HKA angle can be measured with good accuracy with 2D techniques. LEVEL OF EVIDENCE: Level-III diagnostic.
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