ArticleBiomedical engineering online2021
Effect of limb rotation on radiographic alignment measurement in mal-aligned knees.
Article in Biomedical engineering online, 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, 10 citations in OpenAlex.
- Distribution of coronal plane alignment knee phenotypes in Japanese patients with knee osteoarthritis: a comparison of two-dimensional and three-dimensional measurements.Journal of orthopaedics · 2026Article
- Does applying CPAK classification boundaries using measurements from a surgical navigation system result in different class distributions? A retrospective assessment.Journal of experimental orthopaedics · 2026Article
- Three-dimensional verification of osteotomy accuracy in total knee arthroplasty using intraoperative CT imaging: a case series study.BMC musculoskeletal disorders · 2025Article
- Influence of the functional status of the anterior cruciate ligament on the posterior medial femoral condyle among varus osteoarthritic knees.Journal of orthopaedics · 2025Article
- Dynamic patterns of varus deformity among osteoarthritic knees during computer-navigation assisted total knee arthroplasty and their surgical implications.Journal of orthopaedics · 2025Article
- The Accuracy and Reliability of the Photometric Method-A New Noninvasive Tool for Assessing Frontal Lower Limb Alignment.Journal of clinical medicine · 2025Article
- Development of a personalized parametric finite element model of the knee: Evaluation of geometric variables affecting osteoarthritis progression.Journal of orthopaedics · 2025Article
- Gradual Correction of Valgus Deformities of the Tibia Using a Monolateral External Fixator.Strategies in trauma and limb reconstructionArticle
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
purposeLong-leg-radiography (LLR) is commonly used for the measurement of lower limb alignment. However, limb rotations during radiography may interfere with the alignment measurement. This study examines the effect of limb rotation on the accuracy of measurements based on the mechanical and anatomical axes of the femur and tibia, with variations in knee flexion and coronal deformity.
methodsForty-five lower limbs of 30 patients were scanned with CT. Virtual LLRs simulating five rotational positions (neutral, ± 10[Formula: see text], and ± 20[Formula: see text] internal rotation) were generated from the CT images. Changes in the hip-knee-ankle angle (HKA) and the femorotibial angle (FTA) were measured on each image with respect to neutral values. These changes were related to knee flexion and coronal deformity under both weight- and non-weight-bearing conditions.
resultsThe measurement errors of the HKA and FTA derived from limb rotation were up to 4.84 ± 0.66[Formula: see text] and 7.35 ± 0.88[Formula: see text], respectively, and were correlated with knee flexion (p < 0.001) and severe coronal deformity (p < 0.001). Compared with the non-weight-bearing position, the coronal deformity measured in the weight-bearing condition was 2.62[Formula: see text] greater, the correlation coefficients between the coronal deformity and the deviation ranges of HKA and FTA were also greater.
conclusionsFlexion and severe coronal deformity have a significant influence on the measurement error of lower limb alignment. Errors can be amplified in the weight-bearing condition compared with the non-weight-bearing condition. When using HKA and FTA to represent the mechanical axis and the anatomical axis on LLR, limb rotation impacts the anatomic axis more than the mechanical axis in patients with severe deformities. Considering LLR as the gold standard image modality, attention should be paid to the measurement of knee alignment. Especially for the possible errors derived from weight-bearing long-leg radiographs of patients with severe knee deformities.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.