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. und Fürmetz, J. (2020): Three-dimensional assessment of lower limb alignment: Reference values and sex-related differences. In: Knee, Bd. 27, Nr. 2: S. 428-435

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 degrees vs. 87.8 +/- 2.0 degrees;P < .05) and significantly lower mean joint line convergence angle (-2.5 +/- 1.4 degrees vs. -1.3 +/- 1.2;P < .01), but higher mean hip knee ankle angle (178.9 +/- 1.9 degrees vs. 177.8 +/- 23 degrees;P < .05) and mean femoral torsion (182 +/- 9.5 degrees vs. 13.2 +/- 6.4 degrees: 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.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0968-0160
• Sprache: Englisch