David E Westberry1, Linda I Wack2, Roy B Davis2, James W Hardin3. 1. Shriners Hospitals for Children(®) - Greenville, 950 West Faris Road, Greenville, SC, 29605, United States. Electronic address: dwestberry@shrinenet.org. 2. Shriners Hospitals for Children(®) - Greenville, 950 West Faris Road, Greenville, SC, 29605, United States. 3. University of South Carolina, Arnold School of Public Health, 915 Greene Street, Room 448, Columbia, SC, 29208, United States.
Abstract
BACKGROUND: Multiple measurement methods are available to assess transverse plane alignment of the lower extremity. RESEARCH QUESTION: This study was performed to determine the extent of correlation between femoral anteversion assessment using simultaneous biplanar radiographs and three-dimensional modeling (EOS imaging), clinical hip rotation by physical examination, and dynamic hip rotation assessed by gait analysis. METHODS: Seventy-seven patients with cerebral palsy (GMFCS Level I and II) and 33 neurologically typical children with torsional abnormalities completed a comprehensive gait analysis with same day biplanar anterior-posterior and lateral radiographs and three-dimensional transverse plane assessment of femoral anteversion. Correlations were determined between physical exam of hip rotation, EOS imaging of femoral anteversion, and transverse plane hip kinematics for this retrospective review study. RESULTS: Linear regression analysis revealed a weak relationship between physical examination measures of hip rotation and biplanar radiographic assessment of femoral anteversion. Similarly, poor correlation was found between clinical evaluation of femoral anteversion and motion assessment of dynamic hip rotation. Correlations were better in neurologically typical children with torsional abnormalities compared to children with gait dysfunction secondary to cerebral palsy. SIGNIFICANCE: Dynamic hip rotation cannot be predicted by physical examination measures of hip range of motion or from three-dimensional assessment of femoral anteversion derived from biplanar radiographs.
BACKGROUND: Multiple measurement methods are available to assess transverse plane alignment of the lower extremity. RESEARCH QUESTION: This study was performed to determine the extent of correlation between femoral anteversion assessment using simultaneous biplanar radiographs and three-dimensional modeling (EOS imaging), clinical hip rotation by physical examination, and dynamic hip rotation assessed by gait analysis. METHODS: Seventy-seven patients with cerebral palsy (GMFCS Level I and II) and 33 neurologically typical children with torsional abnormalities completed a comprehensive gait analysis with same day biplanar anterior-posterior and lateral radiographs and three-dimensional transverse plane assessment of femoral anteversion. Correlations were determined between physical exam of hip rotation, EOS imaging of femoral anteversion, and transverse plane hip kinematics for this retrospective review study. RESULTS: Linear regression analysis revealed a weak relationship between physical examination measures of hip rotation and biplanar radiographic assessment of femoral anteversion. Similarly, poor correlation was found between clinical evaluation of femoral anteversion and motion assessment of dynamic hip rotation. Correlations were better in neurologically typical children with torsional abnormalities compared to children with gait dysfunction secondary to cerebral palsy. SIGNIFICANCE: Dynamic hip rotation cannot be predicted by physical examination measures of hip range of motion or from three-dimensional assessment of femoral anteversion derived from biplanar radiographs.
Authors: Florian Schmaranzer; Till D Lerch; Klaus A Siebenrock; Moritz Tannast; Simon D Steppacher Journal: Clin Orthop Relat Res Date: 2019-05 Impact factor: 4.176
Authors: Janan Chandrananth; Richard Hannan; Daniel Bouton; Ellen Raney; Susan Sienko; Patrick Do; Jeremy P Bauer Journal: J Pediatr Orthop Date: 2022-07-12 Impact factor: 2.537