ArticleThe American journal of sports medicine2021
A Validated, Automated, 3-Dimensional Method to Reliably Measure Tibial Torsion.
Article in The American journal of sports medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 14 citations in OpenAlex.
- Deep-Learning System for Automatic Measurement of the Femorotibial Rotational Angle on Lower-Extremity Computed Tomography.Journal of imaging informatics in medicine · 2026Article
- [Tibial derotation osteotomy for knee joint pathologies : Indications, surgical technique and overview of the current literature].Orthopadie (Heidelberg, Germany) · 2025Review
- Determining the Origin of Deformity in Torsional Femoral Pathology: A Narrative Review and an Illustrative Pilot Study of a Novel Methodology.Journal of clinical medicine · 2025Review
- Radiological assessment of lower limb torsional deformities: a narrative review.Annals of joint · 2025Review
- 3D osteotomies-improved accuracy with patient-specific instruments (PSI).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- A new method for assessing tibial torsion using computerized tomography in a pediatric population.Frontiers in pediatrics · 2024Article
- Three-dimensional computed tomographic angular measurements of the canine tibia using a bone-centered coordinate system.Frontiers in veterinary science · 2023Article
- Torsional Abnormality: The Forgotten Issue in the Diagnosis and Treatment of the Anterior Knee Pain Patient.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTibial torsion is a twist in the tibia measured as an angle between a proximal axis line and a distal axis line. Abnormal torsion has been associated with a variety of painful clinical syndromes of the lower limb. Measurements of normal tibial torsion reported by different authors vary by 100% (ranging from 20° to 42°), making it impossible to determine normal and pathological levels. PURPOSE: To address the problem of unreliable measurements, this study was conducted to define an automated, validated computer method to calculate tibial torsion. Reliability was compared with current clinical methods. The difference between measurements of torsion generated from computed tomography (CT) and magnetic resonance imaging (MRI) scans of the same bone, and between males and females, was assessed. STUDY
designControlled laboratory study.
methodsPrevious methods of analyzing tibial torsion were reviewed, and limitations were identified. An automated measurement method to address these limitations was defined. A total of 56 cadaveric and patient tibiae (mean ± SD age, 37 ± 15 years; range, 17-71 years; 28 female) underwent CT scanning, and 3 blinded assessors made torsion measurements by applying 2 current clinical methods and the automated method defined in the present article. Intraclass correlation coefficient (ICC) values were calculated. Further, 12 cadaveric tibiae were scanned by MRI, stripped of tissue, and measured using a structured light (SL) scanner. Differences between torsion values obtained from CT, SL, and MRI scans, and between males and females, were compared using
resultsWhen the automated method was used, the tibiae had a mean external torsion of 29°± 11° (range, 9°-65). Automated torsion assessment had excellent reliability (ICC, 1), whereas current methods had good reliability (ICC, 0.78-0.81). No significant difference was found between the torsion values calculated from SL and CT (
conclusionThe use of software to automatically perform measurements ensures consistency, time efficiency, validity, and accuracy not possible with manual measurements, which are dependent on assessor experience. CLINICAL RELEVANCE: We recommend that this method be adopted in clinical practice to establish databases of normal and pathological tibial torsion reference values and ultimately guide management of related conditions.
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