Non-invasive determination of frontal plane lower limb alignment using motion capture technique - An alternative for full-length radiographs in young patients treated by a temporary hemiepiphysiodesis?
Frontal plane alignment
Gait analysis
Leg alignment
Mechanical axis
Valgus
Varus
Journal
Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
11
09
2019
revised:
07
04
2020
accepted:
12
04
2020
pubmed:
26
4
2020
medline:
20
2
2021
entrez:
26
4
2020
Statut:
ppublish
Résumé
Multiple full-length standing anteroposterior radiographs are common practice to quantify the mechanical axis angle (MAA) in young patients with lower limb malalignment in the frontal plane treated with a temporary hemiepiphysiodesis. Is it possible to predict the MAA measured with gold-standard radiographs from a non-invasive method using the marker-based motion capture technique in a standing position and has an increased body mass index (BMI) a negative effect on this prediction? Forty-six children and adolescents with valgus or varus malalignment of the knee were measured several times during the treatment period. In total 175 data sets were evaluated in this prospective study. BMI was included into the linear mixed effect regression to detect the influence of this variable on the prediction model. Bland and Altman plots were obtained to examine methods' agreement. The X-ray-based MAA highly correlated (r = 0.808, p < 0.001) with the marker-based MAA. The association between measurements was stronger in patients with a BMI < 25 (r = 0.881, p < 0.001) than in patients with a BMI ≥ 25 (r = 0.747, p < 0.001). The Bland and Altman plots illustrated a better agreement between both methods for patients with a BMI < 25 (bias of 0.7°) than for patients with a BMI ≥ 25 (bias of 3.7°). Determination of frontal plane lower limb alignment using motion capture technique is an alternative method to assess the MAA non-invasively. The approach is therefore relevant for clinical and scientific use when cumulative radiation dosage becomes a problem or when radiation may be prohibited (e.g. healthy control group). A higher BMI overestimates the valgus malalignment in the motion capture method which may result from excess body tissue and the difficulty in palpating bony landmarks on the skin.
Sections du résumé
BACKGROUND
Multiple full-length standing anteroposterior radiographs are common practice to quantify the mechanical axis angle (MAA) in young patients with lower limb malalignment in the frontal plane treated with a temporary hemiepiphysiodesis.
RESEARCH QUESTION
Is it possible to predict the MAA measured with gold-standard radiographs from a non-invasive method using the marker-based motion capture technique in a standing position and has an increased body mass index (BMI) a negative effect on this prediction?
METHODS
Forty-six children and adolescents with valgus or varus malalignment of the knee were measured several times during the treatment period. In total 175 data sets were evaluated in this prospective study. BMI was included into the linear mixed effect regression to detect the influence of this variable on the prediction model. Bland and Altman plots were obtained to examine methods' agreement.
RESULTS
The X-ray-based MAA highly correlated (r = 0.808, p < 0.001) with the marker-based MAA. The association between measurements was stronger in patients with a BMI < 25 (r = 0.881, p < 0.001) than in patients with a BMI ≥ 25 (r = 0.747, p < 0.001). The Bland and Altman plots illustrated a better agreement between both methods for patients with a BMI < 25 (bias of 0.7°) than for patients with a BMI ≥ 25 (bias of 3.7°).
SIGNIFICANCE
Determination of frontal plane lower limb alignment using motion capture technique is an alternative method to assess the MAA non-invasively. The approach is therefore relevant for clinical and scientific use when cumulative radiation dosage becomes a problem or when radiation may be prohibited (e.g. healthy control group). A higher BMI overestimates the valgus malalignment in the motion capture method which may result from excess body tissue and the difficulty in palpating bony landmarks on the skin.
Identifiants
pubmed: 32334347
pii: S0966-6362(20)30120-X
doi: 10.1016/j.gaitpost.2020.04.011
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
26-32Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest All authors do not have any financial and personal relationships with other people or organizations that could inappropriately influence their work or the outcome of this publication.