使用运动捕捉技术无创性确定额状面下肢对线 - 临时骺板切开术治疗的年轻患者是否可替代全长 X 线片？

Non-invasive determination of frontal plane lower limb alignment using motion capture technique - An alternative for full-length radiographs in young patients treated by a temporary hemiepiphysiodesis?

机构信息

Orthopedic University Hospital Friedrichsheim gGmbH, Movement Analysis Laboratory, Marienburgstraße 2, 60528 Frankfurt/Main, Germany.

出版信息

Gait Posture. 2020 Jun;79:26-32. doi: 10.1016/j.gaitpost.2020.04.011. Epub 2020 Apr 18.

DOI:10.1016/j.gaitpost.2020.04.011

PMID:32334347

Abstract

BACKGROUND

Multiple full-length standing anteroposterior radiographs are common practice to quantify the mechanical axis angle (MAA) in young patients with lower limb malalignment in the frontal plane treated with a temporary hemiepiphysiodesis.

RESEARCH QUESTION

Is it possible to predict the MAA measured with gold-standard radiographs from a non-invasive method using the marker-based motion capture technique in a standing position and has an increased body mass index (BMI) a negative effect on this prediction?

METHODS

Forty-six children and adolescents with valgus or varus malalignment of the knee were measured several times during the treatment period. In total 175 data sets were evaluated in this prospective study. BMI was included into the linear mixed effect regression to detect the influence of this variable on the prediction model. Bland and Altman plots were obtained to examine methods' agreement.

RESULTS

The X-ray-based MAA highly correlated (r = 0.808, p <  0.001) with the marker-based MAA. The association between measurements was stronger in patients with a BMI < 25 (r = 0.881, p <  0.001) than in patients with a BMI ≥ 25 (r = 0.747, p <  0.001). The Bland and Altman plots illustrated a better agreement between both methods for patients with a BMI < 25 (bias of 0.7°) than for patients with a BMI ≥ 25 (bias of 3.7°).

SIGNIFICANCE

Determination of frontal plane lower limb alignment using motion capture technique is an alternative method to assess the MAA non-invasively. The approach is therefore relevant for clinical and scientific use when cumulative radiation dosage becomes a problem or when radiation may be prohibited (e.g. healthy control group). A higher BMI overestimates the valgus malalignment in the motion capture method which may result from excess body tissue and the difficulty in palpating bony landmarks on the skin.

摘要

背景

在使用临时骺环扎术治疗下肢对线不良的年轻患者中，为了定量测量额状面的机械轴角度（MAA），通常会拍摄多个完整的站立前后位 X 线片。

研究问题

是否可以使用基于标记的运动捕捉技术在站立位，从一种非侵入性方法中预测出金标准 X 线片测量的 MAA，并且较高的体重指数（BMI）是否会对这种预测产生负面影响？

方法

46 名膝关节外翻或内翻畸形的儿童和青少年在治疗期间多次接受测量。本前瞻性研究共评估了 175 组数据。将 BMI 纳入线性混合效应回归模型，以检测该变量对预测模型的影响。Bland 和 Altman 图用于检查两种方法的一致性。

结果

基于 X 线的 MAA 与基于标记的 MAA 高度相关（r=0.808，p<0.001）。在 BMI<25 的患者中，两种测量方法的相关性更强（r=0.881，p<0.001），而在 BMI≥25 的患者中，相关性稍弱（r=0.747，p<0.001）。Bland 和 Altman 图表明，对于 BMI<25 的患者，两种方法之间的一致性更好（偏差为 0.7°），而对于 BMI≥25 的患者，一致性稍差（偏差为 3.7°）。