The Deviation of the Mechanical Leg Axis Correlates with an Increased Hip Alpha Angle and Could Be a Predictor of Femoroacetabular Impingement

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2013 Sep 17

PMID 24037618

Citations 4

Authors

Matthias Lahner

Nadine-Lucie Jahnke

Sonja Zirke

Wolfram Teske

Gregor Vetter

Christoph von Schulze Pellengahr

Kiriakos Daniilidis

Marco Hagen

Lars Victor von Engelhardt

Affiliations

Soon will be listed here.

Abstract

Purpose: This study was designed to evaluate whether the mechanical axis deviation (MAD) of the leg correlates with an increased hip alpha angle as described by Nötzli, which is associated with femoroacetabular impingement (FAI).

Methods: In a retrospective analysis, standing full-length anteroposterior radiographs were analysed in patients who suffered from symptomatic leg alignment. The study included 85 radiographs of 80 patients with an average age of 43.11 years (range 18-60 years). Five patients underwent a bilateral long-leg X-ray examination. All radiographs were transferred as Digital Imaging and Communications in Medicine data files from the Picture Archiving and Communications System into the OrthoPlanner software version 2.3.2. The radiographs were measured by one orthopaedic surgeon and one independent radiologist.

Results: The mean value of the alpha angle of Nötzli was 61.43° (49.07-74.04°). A total of 57 (67%) radiographs showed a varus deviation, 25 (29.5%) had a valgus malalignment and three (3.5%) a straight leg axis. Of 82 radiographs, 40 (48.8%) had a moderate axis deviation with a MAD <15 or > - 15 mm and a mean alpha angle of 57.81°, and 42 (51.2%) with extended axis deviation of a MAD > 15 or < - 15 mm had a mean alpha angle of 62.93°; 40 (95.2%) of these 42 showed an alpha angle > 55°. The alpha angle was significantly increased in extended axis deviation compared to moderate axis deviation (P = 0.001).

Conclusions: This study confirmed that increased alpha angles were found significantly at higher degrees of axis deviation on the full-length radiograph. In cases of a MAD >15 or < - 15 mm and symptomatic coxalgia, diagnostic tests must be pursued for FAI.

Citing Articles

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Ossendorff R, Richter J, Heijens E, Schildberg F, Haeder G, Salzmann G J Clin Med. 2023; 12(2).

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Prevalence of femoro-acetabular impingement in international competitive track and field athletes.

Lahner M, Bader S, Walter P, Duif C, von Schulze Pellengahr C, Lukas C Int Orthop. 2014; 38(12):2571-6.

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Five-year results of arthroscopic techniques for the treatment of acetabular chondral lesions in femoroacetabular impingement.

Mancini D, Fontana A Int Orthop. 2014; 38(10):2057-64.

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Biomechanical and functional indicators in male semiprofessional soccer players with increased hip alpha angles vs. amateur soccer players.

Lahner M, von Schulze Pellengahr C, Walter P, Lukas C, Falarzik A, Daniilidis K BMC Musculoskelet Disord. 2014; 15:88.

PMID: 24628720 PMC: 3985593. DOI: 10.1186/1471-2474-15-88.

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