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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-11-2017 | Knee

Measurement of lower limb alignment: there are within-person differences between weight-bearing and non-weight-bearing measurement modalities

Authors: Daphne A. L. Schoenmakers, Peter Z. Feczko, Bert Boonen, Martijn G. M. Schotanus, Nanne P. Kort, Pieter J. Emans

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2017

Abstract

Purpose

Previous studies have compared weight-bearing mechanical leg axis (MLA) measurements to non-weight-bearing measurement modalities. Most of these studies compared mean or median values and did not analyse within-person differences between measurements. This study evaluates the within-person agreement of MLA measurements between weight-bearing full-length radiographs (FLR) and non-weight-bearing measurement modalities (computer-assisted surgery (CAS) navigation or MRI).

Materials and methods

Two independent observers measured the MLA on pre- and postoperative weight-bearing FLR in 168 patients. These measurements were compared to non-weight-bearing measurements obtained by CAS navigation or MRI. Absolute differences in individual subjects were calculated to determine the agreement between measurement modalities. Linear regression was used to evaluate the possibility that other independent variables impact the differences in measurements.

Results

A difference was found in preoperative measurements between FLR and CAS navigation (mean of 2.5° with limit of agreement (1.96 SD) of 6.4°), as well as between FLR and MRI measurements (mean of 2.4° with limit of agreement (1.96 SD) of 6.9°). Postoperatively, the mean difference between MLA measured on FLR compared to CAS navigation was 1.5° (limit of agreement (1.96 SD) of 4.6°). Linear regression analysis showed that weight-bearing MLA measurements vary significantly from non-weight-bearing MLA measurements. Differences were more severe in patients with mediolateral instability (p = 0.010), age (p = 0.049) and ≥3° varus or valgus alignment (p = 0.008).

Conclusion

The clinical importance of this study lies in the finding that there are within-person differences between weight-bearing and non-weight-bearing measurement modalities. This has implications for preoperative planning, performing total knee arthroplasty (TKA), and clinical follow-up after TKA surgery using CAS navigation or patient-specific instrumentation.

Level of evidence

III.

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Title: Measurement of lower limb alignment: there are within-person differences between weight-bearing and non-weight-bearing measurement modalities
Authors: Daphne A. L. Schoenmakers
Peter Z. Feczko
Bert Boonen
Martijn G. M. Schotanus
Nanne P. Kort
Pieter J. Emans
Publication date: 01-11-2017
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-017-4636-1

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Measurement of lower limb alignment: there are within-person differences between weight-bearing and non-weight-bearing measurement modalities

Abstract

Purpose

Materials and methods

Results

Conclusion

Level of evidence

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Abstract

Purpose

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Conclusion

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