Towards a better understanding of knee angular deformities: discrepancies between clinical examination and 2D/3D assessments.
3D imaging
Coronal knee alignment
HKA angle
Knee angular deformities
Radiographs
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
09 Dec 2023
09 Dec 2023
Historique:
received:
11
04
2023
accepted:
20
11
2023
medline:
10
12
2023
pubmed:
10
12
2023
entrez:
9
12
2023
Statut:
aheadofprint
Résumé
Discrepancy between the clinical examination and the 2D/3D radiographs is a common concern in patients with angular or rotational deformities of the lower limbs, as it may alter clinical judgment and subsequent treatment. The aim was to identify such discrepancies and assess determinants that may contribute to their existence. A retrospective chart review was conducted on 329 consecutive patients (658 lower limbs) who underwent physical examination and long-leg biplanar radiographs in our institution between 2013 and 2018 for limb length discrepancy or angular deformity of the knees (varus/valgus). Eleven parameters were measured on 2D and 3D images. 3D measurements were based on standing biplanar X-rays and their 3D reconstructions and were considered the gold standard. Contingency tables and multiple linear regression were used to assess discrepancies between the three modalities and their determinants respectively. Significant mismatches were found between physical examination and 2D images (1% in varus and 1% in valgus), between physical examination and 3D assessment (1% in varus and 4.6% in valgus) as well as between 2 and 3D assessments (1.9% in varus and 7.6% in valgus). The significant determinants of the mismatch between 2 and 3D modalities were frontal pelvic obliquity, neck shaft angle, knee flexion, femoral torsion, and tibial mechanical angle. In the presence of positional and/or morphological deformities, physical examination and 2D assessment of knee alignment could be biased due to axes projection errors. A better understanding of 3D alignment of the knee as part of the entire lower limb from pelvis to toes, may lead to a better diagnosis and subsequently a better treatment of knee angular deformities.
Identifiants
pubmed: 38070015
doi: 10.1007/s00402-023-05153-w
pii: 10.1007/s00402-023-05153-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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