Evaluating Length

Garner, Matthew R.; Dow, Matthew A.; Bixby, Elise C.; Mintz, Doug N.; Widmann, Roger F.; Dodwell, Emily

doi:10.1097/bpo.0000000000000425

Cited by 13 publications

(7 citation statements)

References 24 publications

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“…Guenoun et al found that the EOS 3D modeling technique showed excellent inter- and intra-observer reliabilities, which were better than the reliabilities for 2D measurements [ 12 ]. In addition, several reports found that EOS is more accurate than both computed tomography scanography and conventional radiography [ 13 , 14 ]. Therefore, the present study capitalized on this recent technological advancement to measure 3D structural LLDs, as well as functional LLDs, in patients with AIS.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of functional and structural leg length discrepancy in patients with adolescent idiopathic scoliosis using the EOS imaging system: a prospective comparative study

et al. 2018

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BackgroundTo our knowledge, no studies have reported the exact structural leg length discrepancies (LLDs) in patients with adolescent idiopathic scoliosis (AIS). Therefore, this study aimed to evaluate the differences between functional and structural LLDs and to examine the correlations between LLDs and spinopelvic parameters in patients with AIS using an EOS imaging system, which permits the three-dimensional reconstruction of spinal and lower-limb bony structures.MethodsEighty-two consecutive patients with AIS underwent whole-body EOS radiography in a standing position between August 2014 and March 2016. Functional LLD, lumbar Cobb angle, thoracic curve Cobb angle, coronal balance, and pelvic obliquity were measured using two-dimensional EOS radiography. Structural LLDs were measured using three-dimensional EOS-reconstructed images. The comparison between LLDs was assessed using paired t test. Pearson’s correlation coefficient (r) was used to determine potential correlations between the LLDs and spinopelvic alignment parameters.ResultsFunctional LLDs were significantly larger than structural LLDs (5.6 ± 5.0 vs. 0.2 ± 3.6 mm, respectively; p < 0.001). Both functional and structural LLDs were significantly correlated with pelvic obliquity (r = 0.69 and r = 0.51, respectively; p < 0.001 for both). Functional LLD, but not structural LLD, was correlated with lumbar Cobb angle (r = 0.44, p < 0.001; r = 0.17, p = 0.12, respectively). In addition, functional and structural LLDs were not correlated with thoracic Cobb angle (r = 0.09 and r = − 0.05, respectively; p ≥ 0.68 for both).ConclusionsAlthough patients with AIS often have functional LLDs, structural LLDs tend to be smaller. The correlation between functional LLDs and the lumbar Cobb angle indicates that functional LLDs compensate for the lumbar curve. Thus, the difference between functional and structural LLDs indicates a compensatory mechanism involving extension and flexion of the lower limbs.

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Section: Discussionmentioning

confidence: 99%

Evaluation of functional and structural leg length discrepancy in patients with adolescent idiopathic scoliosis using the EOS imaging system: a prospective comparative study

et al. 2018

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“…Three-dimensional reconstruction of the lower limbs was performed for all subjects [18]. Four 3D radiological leg alignment parameters (including both the leg alignment and femoral parameters) were extracted from this reconstruction (Fig.…”

Section: Methodsmentioning

confidence: 99%

Are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait?

Drongelen

Kaldowski

Tarhan

et al. 2019

BMC Musculoskelet Disord

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BackgroundGait kinematics after total hip replacement only partly explain the differences in the joint moments in the frontal plane between hip osteoarthritis patients after hip replacement and healthy controls. The goal of this study was to determine if total hip replacement surgery affects radiological leg alignment (Hip-Knee-Shaft-Angle, femoral offset, Neck-Shaft-Angle and varus/valgus alignment) and which of these parameters can explain the joint moments, additionally to the gait kinematics.Methods22 unilateral hip osteoarthritis patients who were scheduled for total hip replacement were included in the study. Preoperatively and 1 year postoperatively all patients had biplanar radiographic examinations and 3D gait analysis.ResultsThe operated leg showed significantly (P < 0.05) more varus (1.1°) as well as a larger femoral offset (+ 8 mm) and a larger Hip-Knee-Shaft-Angle (+ 1.3°) after total hip replacement; however no significant differences in the joint moments in the frontal plane compared to healthy controls were found. The hip moment (first half of stance) and the knee moments (first and second half of stance) were mostly determined by the varus/valgus alignment (29% and respectively 36% and 35%). The combination with a kinematic parameter (knee range of motion, foot progression angle) increased the predictive value for the knee moments.ConclusionIn our patient group the joint moments after total hip replacement did not differ from healthy controls, whereas radiological leg alignment parameters changed significantly after the total hip replacement. A combination of these radiological leg parameters, especially the varus alignment, and the deviating kinematics explain the joint moments in the frontal plane during gait after total hip replacement surgery. For surgeons it is important not to create too much of a structural varus alignment by implanting the new hip joint as varus alignment can increase the knee adduction moment and the risk for osteoarthritis of the medial knee compartment.Trial registrationThis study was retrospectively registered with DRKS (German Clinical Trials Register) under the number DRKS00015053. Registered 1st of August 2018.

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“…The accuracy of a slit scanogram in measuring limb length has been widely investigated 13,14,[23][24][25] . The biplanar slot-scanning radiograph technique has been widely used in orthopaedic practices to assess limb length [26][27][28][29] . Overall, the 50th percentiles of the tibial and femoral The slit-like x-ray beam moved down the length of the patient's legs from the hips to the ankles.…”

Section: Discussionmentioning

confidence: 99%

Normative Femoral and Tibial Lengths in a Modern Population of Twenty-First-Century U.S. Children

Chen

Milbrandt

Babadi

et al. 2023

Journal of Bone and Joint Surgery

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Background:The Green-Anderson (GA) leg-length data remain the gold standard for the age-based assessment of leg lengths in children despite their methodologic weaknesses. We aimed to summarize current growth trends among a cross-sectional cohort of modern U.S. children using quantile regression methods and to compare the median femoral and tibial lengths of the modern U.S. children with those of the GA cohort.Methods:A retrospective review of scanograms and upright slot-scanning radiographs obtained in otherwise healthy children between 2008 and 2020 was completed. A search of a radiology registry revealed 3,508 unique patients between the ages of 2 and 18 years for whom a standard-of-care scanogram or slot-scanning radiograph had been made. All patients with systemic illness, genetic conditions, or generalized diseases that may affect height were excluded. Measurements from a single leg at a single time point per subject were included, and the latest available time point was used for children who had multiple scanograms made. Quantile regression analysis was used to fit the lengths of the tibia and femur and overall leg length separately for male patients and female patients.Results:Seven hundred patients (328 female and 372 male) met the inclusion criteria. On average, the reported 50th percentile tibial lengths from the GA study at each time point were shorter than the lengths in this study by 2.2 cm (range, 1.4 to 3.3 cm) for boys and 2 cm (range, 1.1 to 3.1 cm) for girls. The reported 50th percentile femoral lengths from the GA study at each time point were shorter than the lengths in this study by 1.8 cm (range, 1.1 to 2.5 cm) for boys and 1.7 cm (range, 0.8 to 2.3 cm) shorter for girls.Conclusions:This study developed new growth charts for femoral and tibial lengths in a modern U.S. population of children. The new femoral and tibial lengths at nearly all time points are 1 to 3 cm longer than traditional GA data. The use of GA data for epiphysiodesis could result in underestimation of expected childhood growth.Level of Evidence:Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Evaluating Length

Abstract: Level II—diagnostic

Cited by 13 publications

References 24 publications

Evaluation of functional and structural leg length discrepancy in patients with adolescent idiopathic scoliosis using the EOS imaging system: a prospective comparative study

Evaluation of functional and structural leg length discrepancy in patients with adolescent idiopathic scoliosis using the EOS imaging system: a prospective comparative study

Are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait?

Normative Femoral and Tibial Lengths in a Modern Population of Twenty-First-Century U.S. Children

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