Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.
BMC Musculoskelet Disord. 2022 Dec 28;23(1):1136. doi: 10.1186/s12891-022-06099-7.
Conflicting results have been reported regarding the factors that can predict the discrepancy in the coronal alignment of the lower limb between radiographs taken in the standing and supine positions. Therefore, this study aimed to investigate factors that can predict discrepancies in the coronal alignment of the lower limb between radiographs taken in the standing and supine positions.
We retrospectively evaluated the medical records of patients who underwent full-length anteroposterior radiographs of the lower limb in both standing and supine positions between January 2019 and September 2021. The discrepancy in the coronal alignment of the lower limb between the standing and supine radiographs was defined as the absolute value of the difference in the hip-knee-ankle (HKA) angle between the two radiographs, which is presented as the ΔHKA angle. Correlation and regression analyses were performed to analyse the relationship among ΔHKA angle, demographic data, and several radiographic parameters.
In total, 147 limbs (94 patients) were included in this study. The mean ΔHKA angle was 1.3 ± 1.1° (range, 0-6.5°). The ΔHKA angle was significantly correlated with body mass index and several radiographic parameters, including the HKA angle, joint line convergence angle, and osteoarthritis grade. Subsequent multiple linear regression analysis was performed using the radiographic parameters measured on the supine radiographs with the two separate models from the two observers, which revealed that body mass index and advanced osteoarthritis (Kellgren-Lawrence grades 3 and 4) had a positive correlation with the ΔHKA angle.
Body mass index and advanced osteoarthritis affected the discrepancy in the coronal alignment of the lower limb between standing and supine radiographs. A discrepancy in the coronal alignment of the lower limb could be more prominent in patients with an increased body mass index and advanced osteoarthritis, corresponding to Kellgren-Lawrence grades 3 and 4.
关于能预测下肢冠状位对线在站立位和仰卧位 X 线片之间差异的因素，已有相互矛盾的结果报道。因此，本研究旨在探讨能预测下肢冠状位对线在站立位和仰卧位 X 线片之间差异的因素。
我们回顾性评估了 2019 年 1 月至 2021 年 9 月期间行下肢全长正侧位 X 线片的患者的病历。站立位和仰卧位 X 线片下肢冠状位对线差异定义为两张 X 线片髋膝踝角（HKA）差值的绝对值，以 ΔHKA 角表示。采用相关和回归分析来分析 ΔHKA 角与人口统计学数据和几种影像学参数之间的关系。
共纳入 147 条肢体（94 例患者）。平均 ΔHKA 角为 1.3±1.1°（范围，0-6.5°）。ΔHKA 角与体重指数和几种影像学参数显著相关，包括 HKA 角、关节线会聚角和骨关节炎分级。随后，使用仰卧位 X 线片上测量的影像学参数，通过两位观察者的两个独立模型进行多元线性回归分析，结果显示体重指数和晚期骨关节炎（Kellgren-Lawrence 分级 3 和 4）与 ΔHKA 角呈正相关。
体重指数和晚期骨关节炎影响下肢冠状位对线在站立位和仰卧位 X 线片之间的差异。体重指数增加和晚期骨关节炎（对应 Kellgren-Lawrence 分级 3 和 4）的患者下肢冠状位对线差异可能更为显著。
