Relationship Between Lower Limb Torsion and Coronal Morphologies of the Femur and Tibia in Patients with Medial Knee Osteoarthritis

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2020 Apr 19

PMID 32303239

Citations 2

Authors

Shuntaro Nejima

Yasushi Akamatsu

Hideo Kobayashi

Masaki Tsuji

Shota Mitsuhashi

Takahiro Sasaki

Ken Kumagai

Yutaka Inaba

Affiliations

Soon will be listed here.

Abstract

Background: To investigate the relationship between femoral or tibial torsion and hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), or mechanical medial proximal tibial angle (mMPTA) in patients with medial knee osteoarthritis (OA).

Methods: A total of 75 knees were enrolled. Femoral and tibial torsions were measured by superimposing the axial planes of computed tomography images. The relationship between femoral or tibial torsion and HKA, mLDFA, or mMPTA on radiographs was examined.

Results: The mean femoral torsion was 12.2 ± 8.5° internally; femoral internal and external torsions were observed in 70 and 5 knees, respectively. The mean tibial external torsion was 18.0 ± 7.4° externally; tibial external torsion was observed in all 75 knees. Femoral internal and tibial external torsions increased with lower mMPTA (r = 0.33, P = 0.003; r = - 0.32, P = 0.005, respectively) but were not related to HKA or mLDFA.

Conclusion: Femoral and tibial torsions were correlated with varus inclination of the proximal tibia in patients with medial knee OA.

Citing Articles

Coronal alignment does not enable to predict the degree of femoral and tibial torsion.

Grunwald L, Schmidt S, Ahrend M, Histing T, Dobele S J Exp Orthop. 2025; 12(1):e70073.

PMID: 39839857 PMC: 11747137. DOI: 10.1002/jeo2.70073.

Influence of Axial Rotation Between the Femoral Neck and Ankle Joint on Kinematics in Normal Knees: A Cross-Sectional Study.

Kono K, Taketomi S, Yamazaki T, Kage T, Tamaki M, Inui H J Am Acad Orthop Surg Glob Res Rev. 2025; 9(1.

PMID: 39808747 PMC: 11709167. DOI: 10.5435/JAAOSGlobal-D-24-00169.

Coronal Knee Alignment and Tibial Rotation in Total Knee Arthroplasty: A Prospective Cohort Study of Patients with End-Stage Osteoarthritis.

Strahovnik A, Strahovnik I, Fokter S Bioengineering (Basel). 2024; 11(3).

PMID: 38534570 PMC: 10968541. DOI: 10.3390/bioengineering11030296.

Efficacy of a Tibia Counter Rotator System for the Treatment of Internal Tibial Torsion in Children.

Kim S, Suzuki M, Minowa K, Nittono H, Shimizu T Children (Basel). 2022; 9(7).

PMID: 35883954 PMC: 9322744. DOI: 10.3390/children9070970.

References

Yagi T . [A study on torsion of the lower leg in osteoarthritis of the knee. Measurement of leg torsion by computerized tomography]. Nihon Seikeigeka Gakkai Zasshi. 1984; 58(4):405-17. View

Takai S, SAKAKIDA K, Yamashita F, Suzu F, Izuta F . Rotational alignment of the lower limb in osteoarthritis of the knee. Int Orthop. 1985; 9(3):209-15. DOI: 10.1007/BF00268173. View

Eckhoff D, Johnston R, Stamm E, Kilcoyne R, Wiedel J . Version of the osteoarthritic knee. J Arthroplasty. 1994; 9(1):73-9. DOI: 10.1016/0883-5403(94)90140-6. View

Yazdi H, Mallakzadeh M, Farshidfar S, Givehchian B, Daneshparvar H, Behensky H . The effect of tibial rotation on knee medial and lateral compartment contact pressure. Knee Surg Sports Traumatol Arthrosc. 2014; 24(1):79-83. DOI: 10.1007/s00167-014-3321-x. View

Mochizuki T, Tanifuji O, Koga Y, Sato T, Kobayashi K, Nishino K . Sex differences in femoral deformity determined using three-dimensional assessment for osteoarthritic knees. Knee Surg Sports Traumatol Arthrosc. 2016; 25(2):468-476. DOI: 10.1007/s00167-016-4166-2. View

Folinais D, Thelen P, Delin C, Radier C, Catonne Y, Lazennec J . Measuring femoral and rotational alignment: EOS system versus computed tomography. Orthop Traumatol Surg Res. 2013; 99(5):509-16. DOI: 10.1016/j.otsr.2012.12.023. View

Jend H, Heller M, Dallek M, Schoettle H . Measurement of tibial torsion by computer tomography. Acta Radiol Diagn (Stockh). 1981; 22(3A):271-6. DOI: 10.1177/028418518102203a10. View

Enomoto H, Nakamura T, Waseda A, Niki Y, Toyama Y, Suda Y . A novel and reproducible reference axis for distal tibial axial rotation. J Arthroplasty. 2013; 28(5):788-91. DOI: 10.1016/j.arth.2012.11.005. View

Hoiseth A, Reikeras O, Fonstelien E . Evaluation of three methods for measurement of femoral neck anteversion. Femoral neck anteversion, definition, measuring methods and errors. Acta Radiol. 1989; 30(1):69-73. View

10.

Reikeras O, BJERKREIM I, Kolbenstvedt A . Anteversion of the acetabulum and femoral neck in normals and in patients with osteoarthritis of the hip. Acta Orthop Scand. 1983; 54(1):18-23. DOI: 10.3109/17453678308992864. View

11.

Eckhoff D, Johnson K . Three-dimensional computed tomography reconstruction of tibial torsion. Clin Orthop Relat Res. 1994; (302):42-6. View

12.

Landis J, Koch G . The measurement of observer agreement for categorical data. Biometrics. 1977; 33(1):159-74. View

13.

Moussa M . Rotational malalignment and femoral torsion in osteoarthritic knees with patellofemoral joint involvement. A CT scan study. Clin Orthop Relat Res. 1994; (304):176-83. View

14.

Laasonen E, Jokio P, Lindholm T . Tibial torsion measured by computed tomography. Acta Radiol Diagn (Stockh). 1984; 25(4):325-9. DOI: 10.1177/028418518402500413. View

15.

Nagamine R, Miyanishi K, Miura H, Urabe K, Matsuda S, Iwamoto Y . Medial torsion of the tibia in Japanese patients with osteoarthritis of the knee. Clin Orthop Relat Res. 2003; (408):218-24. DOI: 10.1097/00003086-200303000-00028. View

16.

Yagi T, Sasaki T . Tibial torsion in patients with medial-type osteoarthritic knee. Clin Orthop Relat Res. 1986; (213):177-82. View

17.

Duparc F, Thomine J, Simonet J, Biga N . Femoral and tibial bone torsions associated with medial femoro-tibial osteoarthritis. Index of cumulative torsions. Orthop Traumatol Surg Res. 2014; 100(1):69-74. DOI: 10.1016/j.otsr.2013.12.014. View

18.

Turner M . The association between tibial torsion and knee joint pathology. Clin Orthop Relat Res. 1994; (302):47-51. View

19.

Yoshimura N, Muraki S, Oka H, Mabuchi A, En-yo Y, Yoshida M . Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab. 2009; 27(5):620-8. DOI: 10.1007/s00774-009-0080-8. View

20.

Jakob R, HAERTEL M, Stussi E . Tibial torsion calculated by computerised tomography and compared to other methods of measurement. J Bone Joint Surg Br. 1980; 62-B(2):238-42. DOI: 10.1302/0301-620X.62B2.7364840. View