Radiologists should use the hip-knee-ankle angle rather than the mechanical axis deviation to describe knee alignment,Skeletal Radiology

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Radiologists should use the hip-knee-ankle angle rather than the mechanical axis deviation to describe knee alignment
Skeletal Radiology ( IF 1.9 ) Pub Date : 2022-11-14 , DOI: 10.1007/s00256-022-04234-y
Priyam Choudhury ₁ , Scott J Billings ₁ , Joseph M Bestic ₁ , Jeffrey J Peterson ₁ , Rupert O Stanborough ₁ , Hillary W Garner ₁ , Ronnie Sebro ₁

Affiliation

Objective

Preoperative and postoperative coronal knee alignment is an important predictor of total knee arthroplasty (TKA) failure. Radiologists often report the mechanical axis deviation (MAD) rather than hip-knee-ankle angle (HKAA) to describe coronal knee alignment. The aim of this study is to evaluate (i) how well the MAD predicts the HKAA; (ii) if patient height and sex affect the performance of the MAD; and (iii) if the MAD could be measured faster than the HKAA.

Materials and methods

Two hundred patients undergoing hip-to-ankle radiographs for TKA planning were retrospectively reviewed. The MAD and HKAA were measured using previously published methods by the Visage picture archiving and communication systems (PACS) tools. Receiver operator characteristic (ROC) curves were used to evaluate the performance of the MAD to predict HKAA by gender and height. The performance of a linear model was used to predict HKAA from MAD in a prospectively collected cohort of 40 patients. Paired t tests were used for the comparison of time measurement in MAD and HKAA in this cohort.

Results

MAD strongly correlated with HKAA (r = 0.99, p < 0.001); however, the performance of MAD differed by height (p = 0.005) and sex (p < 0.001). There was no significant difference in the time taken to measure HKAA versus MAD (p > 0.05).

Conclusion

HKAA should be used instead of the MAD because it is more clinically relevant and takes the same amount of time to be measured.

中文翻译：

放射科医生应该使用髋膝踝角度而不是机械轴偏差来描述膝关节对齐

客观的

术前和术后冠状膝关节对齐是全膝关节置换术 (TKA) 失败的重要预测指标。放射科医生经常报告机械轴偏差 (MAD) 而不是髋膝踝角 (HKAA) 来描述冠状膝关节对齐。本研究的目的是评估 (i) MAD 预测 HKAA 的程度；(ii) 如果患者身高和性别影响 MAD 的性能；(iii) 是否可以比 HKAA 更快地测量 MAD。

材料和方法

对 200 名接受髋关节 X 光片以进行 TKA 计划的患者进行了回顾性分析。MAD 和 HKAA 是使用 Visage 图片存档和通信系统 (PACS) 工具先前发布的方法测量的。接受者操作特征 (ROC) 曲线用于评估 MAD 按性别和身高预测 HKAA 的性能。在前瞻性收集的 40 名患者队列中，使用线性模型的性能预测 HKAA 和 MAD。配对t检验用于比较该队列中 MAD 和 HKAA 的时间测量。