Three-dimensional assessment of lower limb alignment: Reference values and sex-related differences.

Degen, N; Sass, J; Jalali, J; Kovacs, L; Euler, E; Prall, W C; Böcker, W; Thaller, P H; Fürmetz, J

doi:10.1016/j.knee.2019.11.009

2020

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Title:: Three-dimensional assessment of lower limb alignment: Reference values and sex-related differences.
Document type:: Journal Article
Author(s):: Degen, N; Sass, J; Jalali, J; Kovacs, L; Euler, E; Prall, W C; Böcker, W; Thaller, P H; Fürmetz, J
Abstract:: BACKGROUND: Three-dimensional (3D) preoperative planning and assisted surgery is increasingly popular in deformity surgery and arthroplasty. Reference ranges for 3D lower limb alignment are needed as a prerequisite for standardized analysis of alignment and preoperative planning in 3D, but are not yet established. METHODS: On 60 3D bone models of the lower limbs based on computed tomography data, fifteen parameters per leg were assessed by standardized validated 3D analysis. Distribution parameters and differences between sexes were evaluated. Reference values were generated by adding/subtracting one standard deviation from the mean. RESULTS: Women had a significantly lower mean mechanical lateral distal femoral angle compared with men (86.4 ± 2.1° vs. 87.8 ± 2.0°; P < .05) and significantly lower mean joint line convergence angle (-2.5 ± 1.4° vs. -1.3 ± 1.2; P < .01), but higher mean hip knee ankle angle (178.9 ± 1.9° vs. 177.8 ± 2.3°; P < .05) and mean femoral torsion (18.2 ± 9.5° vs. 13.2 ± 6.4°; P < .05), resulting in a tendency towards valgus alignment and vice versa for men. Differences in mean medial proximal tibial angle were not significant. The mean mechanical axis deviation from the tibial knee joint center was 6.9 ± 7.3 mm medial and 1.4 ± 16.1 mm ventral without significant differences between sexes. CONCLUSIONS: We describe total and sex-related reference ranges for all alignment relevant axes and joint angles of the lower limb. There are sex-related differences in certain alignment parameters, which should be considered in analysis and surgical planning.
Journal title abbreviation:: Knee
Year:: 2020
Journal volume:: 27
Journal issue:: 2
Pages contribution:: 428-435
Fulltext / DOI:: doi:10.1016/j.knee.2019.11.009
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/31806504
Print-ISSN:: 0968-0160
TUM Institution:: Lehrstuhl für Plastische Chirurgie und Handchirurgie (Prof. Machens)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie (Prof. Machens)Lehrstuhl für Plastische Chirurgie und Handchirurgie (Prof. Machens)2020