用髋-跟骨角度评价膝关节骨性关节炎患者和健康人的后脚和膝关节对齐。

Y. Wanezaki, A. Suzuki, Y. Takakubo, Taku Nakajima, S. Toyono, S. Toyoshima, Mitsuhiro Hariu, Soichiro Okada, Hitoshi Ishikawa, M. Takagi
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摘要

臀部到跟骨(HC)视图是一种全腿站立视图,可以看到后脚的细节。本研究的目的是通过与长轴位(L-TCA)比较,探讨HC位(H-TCA)胫骨跟骨角的信度和效度。我们还验证了在全腿站立摄影中常规测量的膝关节关节周围对齐参数是否可以在HC视图中测量。方法选取60名健康志愿者和61例膝关节内侧骨关节炎患者。健康组由2名检查人员测量H-TCA,并评估类内相关系数(ICCs)。然后在健康组和骨关节炎组中测量H-TCA和L-TCA并进行相关性分析。最后,我们测量髋-膝-踝关节角、机械轴偏差比、机械股骨外侧远端角、胫骨内侧近端角和关节线收敛角,以评估HC视图和常规全腿站立x线片的统计学差异和相关性。结果观察者内ICCs为0.86,观察者间ICCs为0.76。健康组H-TCA与L-TCA的相关系数r = 0.87,骨关节炎组r = 0.81,两者呈正相关。在膝关节关节周围的排列参数在HC视图和传统的全腿x线片之间没有显著差异。结论HC视图下的shindfoot评价具有较高的观察者内信度和观察者间信度,与长轴视图下的TCA呈正相关。通过在膝关节手术(如全膝关节置换术)前使用HC视图,可以同时评估其他必要的对齐。
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Evaluation of hindfoot and knee alignment by the hip-to-calcaneus view in patients with knee osteoarthritis and healthy individuals.
BACKGROUND Hip-to-calcaneus (HC) view is a whole-leg standing view that can visualize the hindfoot in detail. The aim of this study was to investigate the reliability and validity of tibiocalcaneal angle in HC view (H-TCA) by comparing it with that in long axial view (L-TCA). We also verified whether periarticular knee alignment parameters, measured conventionally in whole-leg standing radiography, could be measured in HC view. METHOD Sixty healthy volunteers and 61 patients with medial knee osteoarthritis were included. H-TCA was measured by two examiners in the healthy group, and intra-class correlation coefficients (ICCs) were evaluated. H-TCA and L-TCA were then measured in the healthy and osteoarthritis groups and correlated. Finally, we measured hip-knee-ankle angle, mechanical axis deviation ratio, mechanical lateral distal femoral angle, medial proximal tibial angle, and joint-line convergence angle in HC view and conventional whole-leg standing radiography to evaluate statistical differences and correlations. RESULTS The intra-observer and inter-observer ICCs were 0.86 and 0.76, respectively. Correlation coefficients (r) between H-TCA and L-TCA were r = 0.87 in healthy group and r = 0.81 in osteoarthritis group, indicating a strong positive correlation in both groups. There was no significant difference in periarticular knee alignment parameters between HC view and conventional whole-leg radiography. CONCLUSIONS Hindfoot evaluation in HC view showed high intra-observer and inter-observer reliabilities and strong positive correlation with TCA in long axial view. By using HC view before knee surgery, such as total knee arthroplasty, other necessary alignments can be evaluated simultaneously.
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