ArticleOrthopaedic surgery2023
The Relationship between Frontal, Axial Leg Alignment, and Ankle Joint Line Orientation-a Radiographic Analysis of Healthy Subjects.
Article in Orthopaedic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 8 citations in OpenAlex.
- Ankle Alignment Changes After High Tibial Osteotomy due to Valgus-Shaped Distal Tibia.Cartilage · 2026Article
- Coronal plane alignment of the knee phenotypes and ankle joint coronal plane alignment patterns in Egyptian population.World journal of orthopedics · 2026Article
- Assessment and quantification of ipsilateral and contralateral ankle joint alignment changes after unilateral total knee arthroplasty for knee osteoarthritis with varus deformity: a retrospective cohort study.Knee surgery & related research · 2025Article
- Article
- Total ankle arthroplasty versus ankle fusion.Joint diseases and related surgery · 2024Article
- [Three-dimensional analysis of posttraumatic tibial shaft malunion and correction based on the healthy, contralateral leg].Operative Orthopadie und Traumatologie · 2023Review
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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
objectiveAnkle joint line orientation (AJLO) is influenced by the subtalar foot and frontal leg alignment. However, the influence of axial leg alignment on AJLO remains unclear. The study aimed to analyze the influence of frontal, axial leg alignment on AJLO in healthy subjects.
methodsThirty healthy subjects (60 legs) without prior surgery underwent standing biplanar long leg radiograph (LLR) between 2016 and 2020. AJLO was measured in standing long-leg radiographs relative to the ground. Meary's angle and calcaneal pitch were measured. Hip-knee-ankle angle (HKA), femoral antetorsion, and tibial torsion were assessed with SterEOS software (EOS Imaging, Paris, France). LLR was acquired with the feet directing straight anteriorly, which corresponds to a neutral foot progression angle (FPA). The influence of subtalar, frontal, and axial alignment on AJLO was analyzed in a multiple regression model.
resultsAn increase in knee valgus increased relative valgus AJLO by 0.5° (95% CI: 0.2° to 0.7°) per 1° (P < 0.001). A decrease in femoral antetorsion increased relative valgus AJLO by 0.2° (95% CI: 0.1° to 0.2°) per 1° (P < 0.001), whereas Meary's angle and calcaneal pitch did not influence AJLO.
conclusionA link between frontal, axial leg alignment, and AJLO could be demonstrated, indicating that a valgus leg alignment and relative femoral retrotorsion are associated with an increase of valgus AJLO in healthy subjects when placing their feet in a neutral position. Alteration of the frontal, or rotational profile after realignment surgery or by implant positioning might influence the AJLO, when the FPA is kept constant.
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