ArticleJournal of orthopaedic surgery and research2025
Effect of lower limb rotation on radiographic measurements of femoral and tibial joint line obliquity and their association with measurement changes: a digitally reconstructed radiograph evaluation.
Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- There is no standardised measurement approach for medial proximal tibial angle after unicompartmental knee arthroplasty: A systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLower limb rotation at the time of imaging may affect the measurement of joint line angles using plain radiographs, potentially compromising measurement accuracy. Accurate joint line angle assessment is important for orthopaedic surgical planning and limb alignment. This study aimed to investigate changes in distal femoral and proximal tibial joint line angles in response to limb rotation and to evaluate the correlation between these changes using digitally reconstructed radiographs (DRRs) generated from computed tomography (CT) images.
methodsPreoperative CT data from 50 knees scheduled for total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA) at our institution were analysed using TKA planning software. The femur and tibia were aligned perpendicular to their mechanical axes in the coronal and sagittal planes. The surgical epicondylar axis (SEA) and Akagi's line were used as reference axes for femoral and tibial rotation, respectively, with 0° defined as neutral rotation. Each bone was rotated from 20° external rotation (ER) to 20° internal rotation (IR) in 5° increments using the software, and DRR images were generated at each position. The lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and posterior tibial slope (PTS) were measured at each rotational angle. The absolute values, their variations with rotation, and the correlations between each angle and its respective changes were analysed.
resultsAt 0°, the mean ± standard deviation values were 87.5 ± 2.4°, 83.9 ± 2.6°, and 8.4 ± 3.2° for LDFA, MPTA, and PTS, respectively. The mean changes across the range of 20° ER to 20° IR were 0.3° (1.8°-0.6°), 1.1° (1.0°-1.5°), and 6.2° (1.9°-2.4°) for LDFA, MPTA, and PTS, respectively. MPTA was negatively correlated with ΔPTS (r = -0.7). Based on MPTA values, patients were categorised into three groups: <82.5°, 82.5-84.5°, and > 84.5°. ΔPTS was significantly different between the < 82.5° (8.6 ± 2.3°) and 82.5-84.5° (6.9 ± 1.6°) groups, and between the 82.5-84.5° and > 84.5° (4.0 ± 1.9°) groups (P < 0.05 and P < 0.001, respectively).
conclusionsLimb rotation significantly affects PTS, particularly in cases with greater medial inclination of the tibial plateau. Caution should be exercised when using plain radiographs for preoperative planning or postoperative evaluation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.