A comparative assessment of alignment angle of the knee by radiographic and physical examination methods
A comparative assessment of alignment angle of the knee by radiographic and physical examination methods
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DOI：
10.1002/art.21100
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发表时间：
2005-06-01
影响因子：
--
通讯作者：
McDaniel, G
中科院分区：
文献类型：
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作者：
Kraus, VB;Vail, TP;McDaniel, G
Objective.比较全肢X线片（机械轴）的膝关节对线角与使用测角器进行体格检查和其他2种X线片方法测量的解剖轴角。对57名患有放射学骨关节炎（OA）的受试者的114个膝关节进行了膝关节对线角测量，其中至少一个膝关节的Kellgren/Lawrence分级>= 1。机械轴定义为两条线相交形成的角度，一条线从股骨头中心到胫骨棘中心，另一条线从距骨中心到胫骨棘中心。解剖轴定义为2条线形成的角度，每条线均从平分股骨和胫骨的一个点开始，并在胫骨棘尖端的中心会聚。通过3种方法测量解剖轴角：1）使用测角器进行体格检查; 2）后前位（PA）固定屈曲膝关节X线片（解剖轴）; 3）前后位（AP）全肢X线片（解剖轴）。3种方法测量的机械轴角与解剖轴角之间均存在显著相关性：测角器法（r = 0.70，P < 0.0001）、解剖轴法（r = 0.75，P < 0.0001）和解剖轴法（r = 0.65，P < 0.0001）。解剖轴与机械轴平均偏移4.21度（女性3.5度，男性6.4度），所有方法均一致。临床上通过测角器或膝关节X线片测量的膝关节对线与更麻烦和昂贵的全肢X线片测量的角度相关。当无法获得全肢X线片时，这些替代措施有可能提供有关膝关节OA进展风险的有用信息。
Objective. To compare the knee-alignment angle from a full-limb radiograph (mechanical axis) with the anatomic-axis angle as measured by physical examination using a goniometer and by 2 other radiographic methods.Methods. The knee-alignment angle was measured in 114 knees of 57 subjects who had radiographic osteoarthritis (OA), with a Kellgren/Lawrence grade of >= 1 in at least one knee. The mechanical axis was defined as the angle formed by the intersection of 2 lines, one from the center of the head of the femur to the center of the tibial spines, and a second from the center of the talus to the center of the tibial spines. The anatomic axis was defined as the angle formed by 2 lines, each originating from a point bisecting the femur and tibia and converging at the center of the tibial spine tips. The anatomic-axis angle was measured by 3 methods: 1) physical examination using a goniometer, 2) a posteroanterior (PA) fixed-flexion knee radiograph (anatomic(PA) axis), and 3) an anteroposterior (AP) full-limb radiograph (anatomic(AP), axis).Results. Significant correlations were found between the mechanical-axis angle and the anatomic-axis angle measured by each of the 3 methods: by goniometer (r = 0.70, P < 0.0001), by anatomic(PA) axis (r = 0.75, P < 0.0001), and by anatomic(AP), axis (r = 0.65, P < 0.0001). The anatomic axis was offset a mean 4.21 degrees vagus from the mechanical axis (3.5 degrees in women, 6.4 degrees in men), which was consistent across all methods.Conclusion. Knee alignment assessed clinically by goniometer or measured on a knee radiograph is correlated with the angle measured on the more cumbersome and costly full-limb radiograph. These alternative measures have the potential to provide useful information regarding the risk of progression of knee OA when a full-limb radiograph is not available.