Significant differences in femoral torsion values depending on the CT measurement technique

Kaiser, Peter; Attal, R.; Kammerer, Mark; Thauerer, Michael; Hamberger, Lea; Mayr, Raul; Schmoelz, Werner

doi:10.1007/s00402-016-2536-3

Cited by 140 publications

(134 citation statements)

References 27 publications

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…In addition to measuring total torsion, segmental femoral torsion was determined for the proximal metaphysis, the diaphysis, and the distal metaphysis separately. In agreement with the literature we found almost perfect intra-and inter-rater agreement for total femoral torsion measurements [15]. By calculating the ICC we were able to show that the measurement protocol introduced is a reliable tool for evaluation of segmental torsion, as we found substantial to almost perfect intra-and interobserver agreement for all parameters.…”

Section: Discussionsupporting

confidence: 89%

“…However, their data were based only on measurements in MRI [10]. The reliability of total torsion measurement in CT was evaluated in previous studies, and it was reported that depending on the method used significant differences in torsion measurements and their reliability can be found [15,18]. Recently, Kaiser et al reported that total femoral torsion measurements can differ by more than 10°, depending on the measurement technique used [15].…”

Section: Discussionmentioning

confidence: 99%

“…The reliability of total torsion measurement in CT was evaluated in previous studies, and it was reported that depending on the method used significant differences in torsion measurements and their reliability can be found [15,18]. Recently, Kaiser et al reported that total femoral torsion measurements can differ by more than 10°, depending on the measurement technique used [15]. In this study we used the technique described by Murphy et al [11], as high intra-(ICC: 0.95-0.98) and inter-observer agreement (ICC: 0.93) has been reported for this method [15].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Kaiser et al reported that total femoral torsion measurements can differ by more than 10°, depending on the measurement technique used [15]. In this study we used the technique described by Murphy et al [11], as high intra-(ICC: 0.95-0.98) and inter-observer agreement (ICC: 0.93) has been reported for this method [15]. In our collective we found mean total femoral torsion to be 22.6 ± 8.7°, which lies between the measurements published by Kaiser et [10].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

Ferlic

Runer

Seeber

et al. 2017

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose De-rotational osteotomies are indicated in patients with pathologic femoral torsion. However, there is disagreement whether an osteotomy should be performed proximally or distally. Conventionally only the total torsion is measured, which does not allow differentiation between a torsional deformity located in the proximal or distal metaphysis or the diaphysis. The aim of this study is to validate a new multilevel measurement protocol for evaluation of the magnitude of torsion of the respective femoral segments in CT. Patients and methods The torsional profile of 30 femora was evaluated in CT scans. For separate measurements of the torsion of the metaphysis and the diaphysis, four axes where determined: one through the femoral neck, a second determined by the midpoint of the femoral shaft and the lesser trochanter, a third determined by a tangent dorsal to the popliteal surface, and a fourth axis posterior to the condyles. The total femoral torsion was measured between the first and the fourth axis, proximal torsion between the first and the second, mid torsion between the second and the third, and distal torsion between the third and the fourth axis. Four investigators performed all measurements independently and intraclass correlation coefficients (ICC) were calculated to evaluate intra-and inter-rater reliability. Results Average total femoral torsion was 22.6 ± 8.7°, proximal torsion 47.7 ± 10.6°, mid torsion −33.4 ± 9.9°, and distal torsion 8.3 ± 3.2°. Intra-rater ICC ranged between 0.504 and 0.957 and inter-rater ICC between 0.643 and 0.992. The majority of the ICC were graded as Balmost perfect^and some as Bsubstantial^agreement. Conclusion Evaluation of the segmental torsion of the femur allows in-depth analysis of femoral alignment. High reliability was shown for this measuring method in computed tomography, which can be deployed when studying interdependencies between joint pathologies and torsional deformities or when planning the site for an osteotomy. Level of evidence Level III.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

Ferlic

Runer

Seeber

et al. 2017

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…The method has been recorded on more than 500 limbs 92 with mean internal femoral torsion of 24.1 AE 17.4 degrees and mean external tibial torsion of 34.9 AE 15.9 degrees. Findings which were confirmed by Kaiser et al 93 in their study comparing six methods to measure femoral torsion, all with high reliability. Liodakis et al 94 identified sufficient variation in the values yielded from different methods to preclude direct comparison.…”

Section: Axial Planesupporting

confidence: 63%

Lower Limb Deformity Analysis and the Planning of an Osteotomy

et al. 2017

View full text Add to dashboard Cite

This review article provides an overview of lower limb deformity analysis. A brief history and radiographic standards are presented. Deformity analysis is considered in the frontal, sagittal, and axial planes, from simple to more complex cases. The authors recommended analysis methods based on their own experience of deformity correction, while acknowledging that there may be different ways to treat individual cases. Subsequently, methods for osteotomy planning to address the identified deformities are discussed.

show abstract

Promising results following derotational femoral osteotomy in patellofemoral instability with increased femoral anteversion: A systematic review on current indications, outcomes and complication rate

Klasan,

Compagnoni,

Grassi

et al. 2024

J. exp. orthop.

View full text Add to dashboard Cite

PurposePatellofemoral joint instability (PFJI) can surgically be treated with a multitude of approaches, depending on the underlying pathology. In the presence of increased femoral anteversion, some authors have reported good results with a derotational distal femoral osteotomy (DeDFO). The purpose of the study was to investigate the indications, outcomes and complication rate of DeDFO for PFJI.MethodsA systematic review was performed according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta‐analyses) by searching Medline, Embase, Web of Science and Cochrane Library databases through 1 December 2023. Included were levels 1–4 clinical studies of skeletally mature patients undergoing a DeDFO for PFJI irrespective of concomitant procedures. Study characteristics, indications, radiological and clinical outcomes, surgical technique and concomitant procedures, re‐dislocation and complication rate were all analysed, as was methodological quality.ResultsA total of 12 studies including 310 patients (325 knees) were included. Three studies were cohort studies, all others were case series. The mean patient age across the studies was 22 years, and the mean follow‐up was 29.4 months. Femoral anteversion cut‐off was between 20° and 30°. Every study included at least one concurrent soft tissue, bony or combined procedure. Across all studies, one case of re‐dislocation was reported (0.3%) and four implant or osteotomy‐related complications (1.2%) were reported. All studies reported a statistically significant increase in clinical scores.ConclusionThis systematic review of DeDFO for patellofemoral instability in the presence of increased femoral anteversion demonstrates promising clinical results and an extremely low dislocation and complication rate. The heterogeneity of the cut‐off in anteversion and concomitant procedures, especially tibial tubercle osteotomy with seemingly identical results, indicates the need for high‐quality evidence for treating patellofemoral instability. Based upon this systematic review, we strongly recommend that DeDFO be added to the ‘menu à la carte’ of PFJI.Level of EvidenceLevel III Systematic Review.

show abstract

Significant differences in femoral torsion values depending on the CT measurement technique

Cited by 140 publications

References 27 publications

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

Lower Limb Deformity Analysis and the Planning of an Osteotomy

Promising results following derotational femoral osteotomy in patellofemoral instability with increased femoral anteversion: A systematic review on current indications, outcomes and complication rate

Contact Info

Product

Resources

About