Document Type : Original Articles
Authors
- Nasim Rashedi 1
- Bina Eftekharsadat 2
- Neda Dolatkhah 2
- Jafar Soleymanpour 3
- Yaghoub Salekzamani 2
- Soraya Babaie 2
1 Faculty of Medicine and Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
2 Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
3 Department of Orthopedics Surgery, Shohada Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
Background: Photogrammetry is a safe and non-invasive technique for evaluating posture in clinical settings. Body Vision is a novel system that employs photogrammetric principles to assess postural parameters. This study aimed to determine the relationship between clinical, photogrammetric, and radiological techniques in detecting knee angular deformities.
Methods: This cross-sectional study was performed on 53 volunteers of both genders, encompassing a total of 106 lower limbs with complaints of knee pain or knee deformity. Sampling was conducted in a non-random and accessible manner based on predefined inclusion and exclusion criteria. All participants had previously obtained full-length radiographs of their lower limbs. The clinical evaluation included measurements of the anatomical axis, Q angle, and intermalleolar and intercondylar distances. These parameters were also assessed using the Body Vision photogrammetric system while the patient was in a standing position. Data from all three methods were compared using the measured angles and distances.
Results: The evaluations indicated a strong correlation between the photogrammetric and radiological methods regarding the anatomical axis of the lower limb (r = 0.939, p < 0.001). A high correlation was also observed between the clinical and photogrammetric methods for the intermalleolar distance (r = 0.948, p < 0.001) and intercondylar distance (r = 0.927, p < 0.001). For the Q angle, a high but relatively lower correlation was found between the clinical and photogrammetric methods (r = 0.834, p < 0.001). However, a moderate correlation was detected between the clinical measurement of the anatomical axis and both the photogrammetric (r = 0.70) and radiological (r = 0.62) methods.
Conclusion: This study demonstrated a strong correlation between the photogrammetric technique and the gold standard radiological method, indicating that photogrammetry can serve as a viable alternative for evaluating knee angular deviations.
Highlights
Keywords
- Vince KG, Cameron HU, Hungerford DS, Laskin RS, Ranawat CS, Scuderi GR. What would you do?: case challenges in knee surgery. J Arthroplasty. 2005;20:44-50.
- Cherian JJ, Kapadia BH, Banerjee S, Jauregui JJ, Issa K, Mont MA. Mechanical, anatomical, and kinematic axis in TKA: concepts and practical applications. Curr Rev Musculoskelet Med. 2014;7(2):89-95.
- Cooke TDV, Sled EA, Scudamore RA. Frontal plane knee alignment: a call for standardized measurement. J Rheumatol. 2007;34(9):1796.
- Cibere J, Bellamy N, Thorne A, Esdaile JM, McGorm KJ, Chalmers A, et al. Reliability of the knee examination in osteoarthritis: effect of standardization. Arthritis Rheum. 2004;50(2):458-68.
- Navali AM, Bahari LAS, Nazari B. A comparative assessment of alternatives to the full-leg radiograph for determining knee joint alignment. Sports Med Arthrosc Rehabil Ther Technol. 2012;4(1):1-7.
- Loudon JK, Jenkins W, Loudon KL. The relationship between static posture and ACL injury in female athletes. J Orthop Sports Phys Ther. 1996;24(2):91-7.
- Stricker SJ, Faustgen JP. Radiographic measurement of bowleg deformity: variability due to method and limb rotation. J Pediatr Orthop. 1994;14(2):147-51.
- Nguyen HC, van Egmond N, Hevesi M, Weinans H, Gielis WP, Custers RJ. A new protocol for obtaining whole leg radiographs with excellent reproducibility. JCJP. 2022;2(1):100042.
- Sacco IdCN, Alibert S, Queiroz B, Pripas D, Kieling I, Kimura A, et al. Confiabilidade da fotogrametria em relação a goniometria para avaliação postural de membros inferiores. Bra J Phys Ther. 2007;11:411-7.
- Salekzamani Y, Fakhree NA, Azimpouran M, Ebrahimi A, Heravi H, Dolatkhah N. The reliability and validity of body vision system for assessing posture. J Res Clin Med. 2021;9(1):3-.
- Dunk NM, Lalonde J, Callaghan JP. Implications for the use of postural analysis as a clinical diagnostic tool: reliability of quantifying upright standing spinal postures from photographic images. J Manipulative Physiol Ther. 2005;28(6):386-92.
- Furlanetto TS, Candotti CT, Comerlato T, Loss JF. Validating a postural evaluation method developed using a Digital Image-based Postural Assessment (DIPA) software. Comput Methods Programs Biomed. 2012;108(1):203-12.
- Masso PD, Gorton III GE. Quantifying changes in standing body segment alignment following spinal instrumentation and fusion in idiopathic scoliosis using an optoelectronic measurement system. Spine. 2000;25(4):457-62.
- Normand MC, Harrison DE, Cailliet R, Black P, Harrison DD, Holland B. Reliability and measurement error of the biotonix video posture evaluation system—part I: inanimate objects. J Manipulative Physiol Ther. 2002;25(4):246-50.
- De Carvalho RMF, Mazzer N, Barbieri CH. Analysis of the reliability and reproducibility of goniometry compared to hand photogrammetry. Acta Ortop Bras. 2012;20(3):139.
- Sacco IC, Alibert S, Queiroz B, Pripas D, Kieling I, Kimura A, et al. Reliability of photogrammetry in relation to goniometry for postural lower limb assessment. Bra J Phys Ther. 2007;11:411-7.
- Mündermann A, Dyrby CO, Andriacchi TP. A comparison of measuring mechanical axis alignment using three-dimensional position capture with skin markers and radiographic measurements in patients with bilateral medial compartment knee osteoarthritis. The Knee. 2008;15(6):480-5.
- Lim SH, Hong BY, Oh JH, Lee JI. Relationship between knee alignment and the electromyographic activity of quadriceps muscles in patients with knee osteoarthritis. J Phys Ther Sci. 2015;27(4):1261-5.
- Bahadori S, Fatahi H, Ahmadpoor M. The Effect of TheraBand Training on the Q Angle and Distance of Ankle Medial Malleolus in Individuals With Genu Valgum Deformity. PhysTreat -Speci Phys Ther J. 2020;10(3):117-26.
- Paley D, Tetsworth K. Mechanical axis deviation of the lower limbs: preoperative planning of uniapical angular deformities of the tibia or femur. Clin Orthop Relat Res ®. 1992;280:48-64.
- Goulston LM, Sanchez-Santos MT, D'Angelo S, Leyland KM, Hart DJ, Spector TD, et al. A comparison of radiographic anatomic axis knee alignment measurements and cross-sectional associations with knee osteoarthritis. Osteoarthr Cartil. 2016;24(4):612-22.
- Kolber MJ, Hanney WJ. The reliability and concurrent validity of shoulder mobility measurements using a digital inclinometer and goniometer: a technical report. Int J Sports Phys Ther. 2012;7(3):306.
- Hinman RS, May RL, Crossley KM. Is there an alternative to the full‐leg radiograph for determining knee joint alignment in osteoarthritis? Arthritis Rheum. 2006;55(2):306-13.
- Ribeiro AFM, Bergmann A, Lemos T, Pacheco AG, Russo MM, de Oliveira LAS, de Carvalho Rodrigues E. Reference values for human posture measurements based on computerized photogrammetry: a systematic review. J Manipulative Physiol Ther. 2017;40(3):156-68.
- Souza JA, Pasinato F, Basso D, Corrêa ECR, Silva AMTd. Biophotogrammetry: reliability of measurements obtained with a posture assessment software (SAPO). Rev. Bras. Cineantropometria Desempenho Hum. 2011;13:299-305.
- Ferreira EAG, Duarte M, Maldonado EP, Burke TN, Marques AP. Postural assessment software (PAS/SAPO): validation and reliabiliy. Clinics. 2010;65:675-81.
- Chevidikunnan MF, Al Saif A, Pai H, Mathias L. Comparing goniometric and radiographic measurement of Q angle of the knee. Asian Biomed. 2015;9(5):631-6.
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