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A comparison of five approaches to measurement of anatomic knee alignment from radiographs.

Publication ,  Journal Article
McDaniel, G; Mitchell, KL; Charles, C; Kraus, VB
Published in: Osteoarthritis Cartilage
February 2010

OBJECTIVE: The recent recognition of the correlation of the hip-knee-ankle angle (HKA) with femur-tibia angle (FTA) on a standard knee radiograph has led to the increasing inclusion of FTA assessments in OA studies due to its clinical relevance, cost effectiveness and minimal radiation exposure. Our goal was to investigate the performance metrics of currently used methods of FTA measurement to determine whether a specific protocol could be recommended based on these results. METHODS: Inter- and intra-rater reliability of FTA measurements were determined by intraclass correlation coefficient (ICC) of two independent analysts. Minimal detectable differences were determined and the correlation of FTA and HKA was analyzed by linear regression. Differences among methods of measuring HKA were assessed by ANOVA. RESULTS: All five methods of FTA measurement demonstrated high precision by inter- and intra-rater reproducibility (ICCs>or=0.93). All five methods displayed good accuracy, but after correction for the offset of FTA from HKA, the femoral notch landmark method was the least accurate. However, the methods differed according to their minimal detectable differences; the FTA methods utilizing the center of the base of the tibial spines or the center of the tibial plateau as knee center landmarks yielded the smallest minimal detectable differences (1.25 degrees and 1.72 degrees, respectively). CONCLUSION: All methods of FTA were highly reproducible, but varied in their accuracy and sensitivity to detect meaningful differences. Based on these parameters we recommend standardizing measurement angles with vertices at the base of the tibial spines or the center of the tibia and comparing single-point and two-point methods in larger studies.

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Published In

Osteoarthritis Cartilage

DOI

EISSN

1522-9653

Publication Date

February 2010

Volume

18

Issue

2

Start / End Page

273 / 277

Location

England

Related Subject Headings

  • Tibia
  • Reproducibility of Results
  • Radiography
  • Osteoarthritis, Knee
  • Observer Variation
  • Middle Aged
  • Male
  • Humans
  • Femur
  • Female
 

Citation

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McDaniel, G., Mitchell, K. L., Charles, C., & Kraus, V. B. (2010). A comparison of five approaches to measurement of anatomic knee alignment from radiographs. Osteoarthritis Cartilage, 18(2), 273–277. https://doi.org/10.1016/j.joca.2009.10.005
McDaniel, G., K. L. Mitchell, C. Charles, and V. B. Kraus. “A comparison of five approaches to measurement of anatomic knee alignment from radiographs.Osteoarthritis Cartilage 18, no. 2 (February 2010): 273–77. https://doi.org/10.1016/j.joca.2009.10.005.
McDaniel G, Mitchell KL, Charles C, Kraus VB. A comparison of five approaches to measurement of anatomic knee alignment from radiographs. Osteoarthritis Cartilage. 2010 Feb;18(2):273–7.
McDaniel, G., et al. “A comparison of five approaches to measurement of anatomic knee alignment from radiographs.Osteoarthritis Cartilage, vol. 18, no. 2, Feb. 2010, pp. 273–77. Pubmed, doi:10.1016/j.joca.2009.10.005.
McDaniel G, Mitchell KL, Charles C, Kraus VB. A comparison of five approaches to measurement of anatomic knee alignment from radiographs. Osteoarthritis Cartilage. 2010 Feb;18(2):273–277.
Journal cover image

Published In

Osteoarthritis Cartilage

DOI

EISSN

1522-9653

Publication Date

February 2010

Volume

18

Issue

2

Start / End Page

273 / 277

Location

England

Related Subject Headings

  • Tibia
  • Reproducibility of Results
  • Radiography
  • Osteoarthritis, Knee
  • Observer Variation
  • Middle Aged
  • Male
  • Humans
  • Femur
  • Female