Femoral Version and Tibial Torsion are Not Associated With Hip or Knee Arthritis in a Large Osteological Collection

Weinberg, Douglas S.; Park, Paul J.; Morris, William Z.; Liu, Raymond W.

doi:10.1097/bpo.0000000000000604

Cited by 47 publications

(18 citation statements)

References 53 publications

(60 reference statements)

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“…Arthritis grading was performed by two authors (DSW, RWL) and has previously been reported. 15 , 16 These two individuals carefully studied a large number of specimens together to establish grading systems for the hip and knee joints. Arthritis of the proximal femur and acetabulum were graded from zero to three and combined to form a composite hip measurement, graded zero to six.…”

Section: Methodsmentioning

confidence: 99%

Relationship between pelvic incidence and osteoarthritis of the hip

Gebhart

Weinberg

Bohl

et al. 2016

Bone & Joint Research

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ObjectivesSagittal alignment of the lumbosacral spine, and specifically pelvic incidence (PI), has been implicated in the development of spine pathology, but generally ignored with regards to diseases of the hip. We aimed to determine if increased PI is correlated with higher rates of hip osteoarthritis (HOA). The effect of PI on the development of knee osteoarthritis (KOA) was used as a negative control.MethodsWe studied 400 well-preserved cadaveric skeletons ranging from 50 to 79 years of age at death. Each specimen’s OA of the hip and knee were graded using a previously described method. PI was measured from standardised lateral photographs of reconstructed pelvises. Multiple regression analysis was performed to determine the relationship between age and PI with HOA and KOA.ResultsThe mean age was 60.2 years (standard deviation (sd) 8.1), and the mean PI was 46.7° (sd 10.7°). Multiple regression analysis demonstrated a significant correlation between increased PI and HOA (standardised beta = 0.103, p = 0.017). There was no correlation between PI and KOA (standardised beta = 0.003, p = 0.912).ConclusionHigher PI in the younger individual may contribute to the development of HOA in later life.Cite this article: Dr J. J. Gebhart. Relationship between pelvic incidence and osteoarthritis of the hip. Bone Joint Res 2016;5:66–72. DOI: 10.1302/2046-3758.52.2000552.

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Section: Methodsmentioning

confidence: 99%

Relationship between pelvic incidence and osteoarthritis of the hip

Gebhart

Weinberg

Bohl

et al. 2016

Bone & Joint Research

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“…8,9 A spine grading system was modified, 10 and a previously validated grading system for the hip and knee was used. 11 Spine osteoarthritis was evaluated with a scale from 0 to 4 at each vertebral joint level, from L1 to L2 through L5 to S1. Measurements from each level were averaged to represent a composite spine arthritis measurement, graded from 0 to 4.…”

Section: Arthritis Gradingmentioning

confidence: 99%

The Association of Tibia Femur Ratio and Degenerative Disease of the Spine, Hips, and Knees

Weinberg

Liu²

2017

Journal of Pediatric Orthopaedics

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“…17 A proximal reference line parallel to a tangent line drawn at the anterior articular cartilage edge of the medial and the lateral tibial plateau has been described, 55 but due to the need to clearly observe local anatomic features, this application is limited to dry bone studies. 9,51 The 2 most clinically applicable methods we identified from previously proposed methods were the posterior tangent to the tibial condyles proximally 31,34,39 and the axis through a manually selected slice in the proximal tibia that has the widest transverse condylar diameter. 16 Limitations regarding both of these have been discussed above, specifically the challenges of clearly identifying proximal tibial morphology to apply the former method and of selecting the correct slice level and landmarks manually in the latter method.…”

Section: Discussionmentioning

confidence: 99%

A Validated, Automated, 3-Dimensional Method to Reliably Measure Tibial Torsion

et al. 2021

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Background: Tibial torsion is a twist in the tibia measured as an angle between a proximal axis line and a distal axis line. Abnormal torsion has been associated with a variety of painful clinical syndromes of the lower limb. Measurements of normal tibial torsion reported by different authors vary by 100% (ranging from 20° to 42°), making it impossible to determine normal and pathological levels. Purpose: To address the problem of unreliable measurements, this study was conducted to define an automated, validated computer method to calculate tibial torsion. Reliability was compared with current clinical methods. The difference between measurements of torsion generated from computed tomography (CT) and magnetic resonance imaging (MRI) scans of the same bone, and between males and females, was assessed. Study Design: Controlled laboratory study. Methods: Previous methods of analyzing tibial torsion were reviewed, and limitations were identified. An automated measurement method to address these limitations was defined. A total of 56 cadaveric and patient tibiae (mean ± SD age, 37 ± 15 years; range, 17-71 years; 28 female) underwent CT scanning, and 3 blinded assessors made torsion measurements by applying 2 current clinical methods and the automated method defined in the present article. Intraclass correlation coefficient (ICC) values were calculated. Further, 12 cadaveric tibiae were scanned by MRI, stripped of tissue, and measured using a structured light (SL) scanner. Differences between torsion values obtained from CT, SL, and MRI scans, and between males and females, were compared using t tests. SPSS was used for all statistical analysis. Results: When the automated method was used, the tibiae had a mean external torsion of 29°± 11° (range, 9°-65). Automated torsion assessment had excellent reliability (ICC, 1), whereas current methods had good reliability (ICC, 0.78-0.81). No significant difference was found between the torsion values calculated from SL and CT ( P = .802), SL and MRI ( P = .708), or MRI and CT scans ( P = .826). Conclusion: The use of software to automatically perform measurements ensures consistency, time efficiency, validity, and accuracy not possible with manual measurements, which are dependent on assessor experience. Clinical Relevance: We recommend that this method be adopted in clinical practice to establish databases of normal and pathological tibial torsion reference values and ultimately guide management of related conditions.

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Femoral Version and Tibial Torsion are Not Associated With Hip or Knee Arthritis in a Large Osteological Collection

Abstract: These results support the practice of treating tibial torsion and femoral anteversion based on the symptomatology of the patient. Parents of asymptomatic children can be reassured that long-term consequences are unlikely.

Cited by 47 publications

References 53 publications

Relationship between pelvic incidence and osteoarthritis of the hip

Relationship between pelvic incidence and osteoarthritis of the hip

The Association of Tibia Femur Ratio and Degenerative Disease of the Spine, Hips, and Knees

A Validated, Automated, 3-Dimensional Method to Reliably Measure Tibial Torsion

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