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Assessment of lower limb alignment: supine weight-bearing CT scanograms compared with a standing full-length radiograph

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Abstract

Purpose

We identified limb misalignment by applying personalized axial force while the limb was in a supine position to mimic a standing posture. This study aimed to confirm the accuracy of evaluating lower limb alignment using supine weight-bearing CT scanograms.

Methods

We prospectively compared measurements of the weight-bearing line ratio (WBL), hip-knee-ankle (HKA) angle, and joint convergence angle (JLCA) in 46 sets of supine weight-bearing CT scanograms with those obtained from full-length standing anteroposterior lower extremity radiographs. We achieved the weight-bearing CT scanograms by applying six different levels of axial force: zero, 1/5 of body weight, 2/5 of body weight, 3/5 of body weight, 4/5 of body weight, and full body weight. We assessed the impact of age, body mass index, HKA, and JLCA on the observed mechanical axis deviation differences between the two methods.

Result

The average absolute difference between standing radiographs and supine CT scanograms was 4.32% for the WBL ratio (p < 0.05), 1.25° for HKA (p < 0.05), and 0.46 for JLCA (p < 0.05). The mean absolute difference was minimal when applying full body weight axial pressure during CT scanograms (p > 0.05). Age, body mass index, HKA, and JLCA had no effect on the deviation in the mechanical axis measurements obtained through supine weight-bearing CT scanograms with full body weight.

Conclusion

No significant differences were found in assessing lower limb alignment between standing radiographs and supine weight-bearing CT scanograms with full body weight. Weight-bearing CT scanograms prove to be a valuable method for assessing lower limb alignment while in a supine position.

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Data Availability

The data that support the findings of this study are available from the corresponding author, [Chen Zhao], upon reasonable request.

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Funding

This work was supported by the Ethics Committee of Scientific research program of Shaanxi Provincial Department of Education (21JK0892) and the Research project of the Second Affiliated Hospital of Xi’an Medical College (20KY0101).

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Author notes

  1. These authors XueJiao Liu and Bing Zhang contributed equally to this work.

Authors and Affiliations

  1. The Affiliated Hospital of Northwest University Xi’an No 3 Hospital, Xi’an, China

    XueJiao Liu

  2. The Second Affiliated Hospital of Xi’an Medical University, Xi’an 710038, China

    Bing Zhang, Chen Zhao & Jin Kang

  3. The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, China

    Lihong Fan

Authors
  1. XueJiao Liu
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  2. Bing Zhang
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  3. Chen Zhao
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  4. Lihong Fan
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  5. Jin Kang
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Corresponding author

Correspondence to Chen Zhao.

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Liu, X., Zhang, B., Zhao, C. et al. Assessment of lower limb alignment: supine weight-bearing CT scanograms compared with a standing full-length radiograph. Skeletal Radiol (2024). https://doi.org/10.1007/s00256-024-04637-z

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  • DOI: https://doi.org/10.1007/s00256-024-04637-z

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