ArticleBMC musculoskeletal disorders2020
The effect of knee joint rotation in the sagittal and axial plane on the measurement accuracy of coronal alignment of the lower limb.
Article in BMC musculoskeletal disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- High variability exists in 3D leg alignment analysis, but underlying principles that might lead to agreement on a universal framework could be identified: A systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Pooled it
- Influence of axial limb rotation on radiographic lower limb alignment: a systematic review.Archives of orthopaedic and trauma surgery · 2022Pooled it
- Three-dimensional lower limb alignment in healthy Chinese adults: Gender-specific phenotypes and ethnic variations for personalised correction.Journal of experimental orthopaedics · 2026Article
- Combining deep learning with statistical shape modelling enables automated lower limb measurements with observer-level reliability using weight-bearing computed tomography.Journal of experimental orthopaedics · 2026Article
- Assessing joint line obliquity in valgus-producing high tibial osteotomy: A scoping review of the literature.Journal of orthopaedics · 2025Review
- Reliability and Reproducibility of the EOS 3D Imaging System in Measuring TT-TG Distance in Patients With Recurrent Patellar Dislocation.Orthopaedic journal of sports medicine · 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
- A structured framework for standardized 3D leg alignment analysis: An international Delphi consensus study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Five-Step Knee Adjustment Manipulation Based on the 'Muscle and Bone Balance' Principle for Treating Knee Osteoarthritis: Study Protocol for a Randomized Controlled Trial.Journal of pain research · 2025Article
- Radiological Approach to Assessment of Lower-Limb Alignment-Coronal and Transverse Plane Analysis.Journal of clinical medicine · 2024Review
- The posterior tibial slope affects the measurement reliability regarding the radiographic parameter of the knee.BMC musculoskeletal disorders · 2024Article
- Linear correlation between patellar positioning and rotation of the lower limb in radiographic imaging: a 3D simulation study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Changes in Parameters after High Tibial Osteotomy: Comparison of EOS System and Computed Tomographic Analysis.Journal of clinical medicine · 2023Article
- Custom TKA enables adequate realignment with minimal ligament release and grants satisfactory outcomes in knees that had prior osteotomies or extra-articular fracture sequelae.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Factor affecting the discrepancy in the coronal alignment of the lower limb between the standing and supine radiographs.BMC musculoskeletal disorders · 2022Article
- Comparison of Lower-Limb Alignment in Patients with Advanced Knee Osteoarthritis: EOS Biplanar Stereoradiography versus Conventional Scanography.Clinics in orthopedic surgery · 2022Article
- Sagittal femoral bowing contributes to distal femoral valgus angle deviation in malrotated preoperative radiographs.BMC musculoskeletal disorders · 2022Article
- Rapid X-Ray-Based 3-D Finite Element Modeling of Medial Knee Joint Cartilage Biomechanics During Walking.Annals of biomedical engineering · 2022Article
- Association of alignment variables, posteromedial tibial cartilage wear and anterior cruciate ligament insufficiency in participants with varus knee osteoarthritis: a cross-sectional study.International orthopaedics · 2022Article
- Evaluation of the reliability of lower extremity alignment measurements using EOS imaging system while standing in an even weight-bearing posture.Scientific reports · 2021Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough the measurement of coronal alignment of the lower limb on conventional full-length weight-bearing anteroposterior (FLWAP) radiographs was reported to be influenced by the knee joint rotation, no comparative analysis was performed considering the effects of knee joint rotation on the sagittal and axial planes simultaneously using the three-dimensional images while taking into account the actual weight-bearing conditions. The aim of this study was to investigate the effect of knee joint rotation on the measurement accuracy of coronal alignment of the lower limb on the FLWAP radiograph.
methodsRadiographic images of 90 consecutive patients (180 lower limbs) who took both the FLWAP radiograph and the EOS image were retrospectively reviewed. The relationship among delta values of mechanical tibiofemoral angle (mTFA) between the FLWAP radiographs and the EOS images (ΔmTFA), knee flexion/extension angle (sagittal plane rotation) on the EOS images, and patellar rotation (axial plane rotation) on the FLWAP radiographs were analyzed. Further, subgroup analysis according to each direction of knee joint rotation was performed.
resultsThere was a significant correlation between ΔmTFA and sagittal plane rotation (r = 0.368, P < 0.001), whereas axial plane rotation was not correlated. In the analysis according to the direction, statistically significant correlation was observed only in the knee flexion group (r = 0.399, P < 0.001). The regression analysis showed a significant linear relationship between ΔmTFA and sagittal plane rotation (r
conclusionThe measurement accuracy of coronal alignment of the lower limb on the FLWAP radiographs would be influenced by knee flexion, specifically when there is any subtle rotation of the knee joint in the axial plane. A strict patellar forward position without axial plane rotation of the knee could provide accurate results of the measurement even if there is a fixed flexion contracture of the knee.
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