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Comparison of Lower-Limb Alignment in Patients with Advanced Knee Osteoarthritis: EOS Biplanar Stereoradiography versus Conventional Scanography

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Author(s)
Hyeong-Uk ChoiDu-Han KimSi-Wook LeeByung-Chan ChoiKi-Cheor Bae
Keimyung Author(s)
Kim, Du HanLee, Si WookBae, Ki Cheor
Department
Dept. of Orthopedic Surgery (정형외과학)
Journal Title
Clin Orthop Surg
Issued Date
2022
Volume
14
Issue
3
Keyword
Knee osteoarthritisAlignmentBiplanar steroradiographyScanoramTotal knee arthroplasty
Abstract
Background:
Accurate measurement of the lower limb alignment is one of the most crucial factors in advanced knee osteoarthritis patients scheduled for surgery. Recently, EOS biplanar stereoradiography with three-dimensional reconstruction was developed. The purpose of this study was to compare radiographic parameters between conventional scanography and EOS in patients with advanced knee osteoarthritis who need surgical treatment.

Methods:
A total of 52 consecutive patients (104 knees) with bilateral knee osteoarthritis of advanced stage (Kellgren-Lawrence [KL] grade 3 or 4) were retrospectively reviewed. We measured the hip-knee-ankle angle (HKA) on conventional scanograms. In EOS, we measured HKA, hip-knee-shaft angle, mechanical lateral distal femoral angle, and mechanical medial proximal tibial angle. To evaluate sagittal and axial plane alignment, knee flexion angle (KFA), and knee joint rotation (KJR) were also measured.

Results:
Ninety knees were KL grade 4, and 14 knees were grade 3. The average HKA was 10.14° ± 6.16° on conventional scanograms and 11.26° ± 6.21° in EOS. HKA was greater in EOS than on conventional scanograms, and the difference (1.12°; range, −1.07° to 3.22°) was statistically significant (p < 0.001). Significant correlations were observed on the difference in HKA and mechanical medial proximal tibial angle (r = –0.198, p = 0.044), KFA (r = 0.193, p = 0.049), and KJR (r = 0.290, p = 0.003). In multivariable linear regression analysis, the difference in HKA had significant relationship with KFA (β = 0.286, p = 0.003) and KJR (β = 0.363, p < 0.001).

Conclusions:
HKA measured on conventional scanograms and in EOS differed significantly and the difference had a significant correlations with KFA, KJR, and medial proximal tibial angle. Surgeons can consider these results before orthopedic surgery in patients who have advanced knee osteoarthritis.
Keimyung Author(s)(Kor)
김두한
이시욱
배기철
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2005-4408
Source
https://ecios.org/DOIx.php?id=10.4055/cios21050
DOI
10.4055/cios21050
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44520
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
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