The Effect of Tibial Rotation on Varus Deformity Measurement

McCann, Heather; Stanitski, Deborah F.; Barfield, William R.; Leupold, John A.

doi:10.1097/01.bpo.0000217722.07008.34

Cited by 9 publications

(8 citation statements)

References 6 publications

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“…Rotational deformity of the tibia often complicates varus deformity and has a significant effect on axial malalignment. 16,17 In future, we plan to investigate the relationship between rotational and axial malalignment using CT in achondroplastic patients.…”

Section: Discussionmentioning

confidence: 99%

Development of genu varum in achondroplasia

Lee

Song

Mahajan

et al. 2007

The Journal of Bone and Joint Surgery. British volume

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Genu varum in the achondroplastic patient has a complex and multifactorial aetiology. There is little mention in the literature of the role of fibular overgrowth. Using the ratio of fibular to tibial length as a measurement of possible fibular overgrowth, we have related it to the development of genu varum. Full-length standing anteroposterior radiographs of 53 patients with achondroplasia were analysed. There were 30 skeletally-immature and 23 skeletally-mature patients. Regression analysis was performed in order to determine if there was a causal relationship between fibular overgrowth and the various indices of alignment of the lower limb. Analysis showed that the fibular to tibial length ratio had a significant correlation with the medial proximal tibial angle and the mechanical axial deviation in the skeletally-immature group. We conclude that there is a significant relationship between fibular overgrowth and the development of genu varum in the skeletally-immature achondroplastic patient.

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Section: Discussionmentioning

confidence: 99%

Development of genu varum in achondroplasia

Lee

Song

Mahajan

et al. 2007

The Journal of Bone and Joint Surgery. British volume

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“…Assessing knee joint alignment in the frontal plane does not sufficiently take into account the various influencing factors of the sagittal or longitudinal planes. Even with standardized radiography (taking into consideration the position of the foot and leg rotation), there is a measurement inaccuracy in the evaluation of radiographs of about 1.1°–1.6° [2, 8, 10, 16]. Moreover, the significant exposure to radiation involved in obtaining full‐leg radiographs cannot be ignored, thus calling into question their use in both individual follow‐up and cross‐sectional studies.…”

Section: Introductionmentioning

confidence: 99%

Determining knee joint alignment using digital photographs

Schmitt

Kappel

Moser

et al. 2008

Knee Surg Sports Traumatol Arthr

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The objective of this work is to find out how reliably knee joint alignment can be measured from a standardized photograph and what influence changes in the standing position have on the angles measured. The interrater, intrarater, and test-retest reliability were evaluated. The influence of image-object distance, the distance between the legs and leg rotation on the measured angles was evaluated. In addition to the digital photographs, 10 full-length radiographs were obtained in an upright position to determine whether the measured angles represent the anatomic axis or mechanical axis. There was high correlation between the interrater (ICC 0.997), intrarater (ICC 0.989) and test-retest reliability (ICC 0.904). Only slight deviation was found with the changes in radiograph-object distance (0 degrees -1.8 degrees ). With feet together varus malalignment was greater. Leg rotation showed a strong influence on the measured results (ICC 0.658). The angle measured in the digital photographs reflects the mechanical axis with only slight deviation (0.12 degrees -1.9 degrees ). The measurement of the clinical axis using standardized radiography is highly reliable and can be used for individual follow-up of varus and valgus malalignments.

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“…9 Similarly, even standardized radiography with well-defined positioning of the foot and leg rotation has displayed inaccuracy in the evaluation of radiographs ranging from 1.1° to 1.6°. [10][11][12][13] However, the introduction of digitalization of radiographic examination, as well as computerized reading programs, has increased the reliability of the mechanical axis determination considerably, as found in the current study. In addition, a computerized reading program was able to increase the reliability of photographic measurement of the mechanical axis to an acceptable level (SD, 1.3°), as demonstrated in the current study.…”

Section: Discussionmentioning

confidence: 55%

Mechanical Axis of the Lower Extremity Determined by a New Digital Photographic Method

Simonsen¹,

Thomsen²,

Skou³

et al. 2013

Orthopedics

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Assessment of the mechanical axis is routine during the examination of patients with lower extremity pain. Long-leg radiographic examination is the gold standard for exact measurement, but it is associated with a significant radiation dose. An alternative method to examine the mechanical axis has been warranted. This article validates a newly developed computerized photograph method to calculate the mechanical axis using a digital photograph. The location of the center of the femoral head was calculated using ink marks on both superior iliac spines. Twenty-five patients (10 women and 15 men) had both legs examined using the photographic method and long-leg radiography examination. The digital photograph method was found to be highly reliable. The interobserver absolute mean difference was 0.99°±0.85°, and the intraobserver absolute mean difference (day-to-day variation) was 1.04°±0.81°. The mechanical axis determined by the 2 methods was highly correlated (R=0.943). The long-leg radiography method was within an average of ±1.88° of the photographic method, with a 95% probability. The photographic method appears to be an effective alternative to conventional long-leg radiography. The photographic method seems convenient in the routine examination of patients with leg pain and children with suspected axial deformity and for follow-up after treatment for malalignment. Calculation coefficients for children and a possible racial difference remain to be studied.

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The Effect of Tibial Rotation on Varus Deformity Measurement

Abstract: Clinically, the results of this study support the importance of proper alignment of the tibia during radiography to more precisely template surgery.

Cited by 9 publications

References 6 publications

Development of genu varum in achondroplasia

Development of genu varum in achondroplasia

Determining knee joint alignment using digital photographs

Mechanical Axis of the Lower Extremity Determined by a New Digital Photographic Method

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