Abstract
Introduction
The importance of lower-limb compensation in patients with spinal malalignment due
to spinal pathologies has been emphasized. The latest whole-body X-ray images (WBX)
have enabled evaluations of whole-body alignment from head to toe. However, WBX is
still not commonly available. Thus, the present study aimed to examine an alternative
measurement method of the femoral angle on usual full-spine X-ray images (FSX) that
approximates the femoral angle on WBX.
Methods
A total of 50 patients (age, 52.8 ± 25.3 years; female, n = 26; male, n = 24) underwent
WBX and FSX. The following parameters were measured on lateral view X-rays: WBX and
FSX femoral angle (angle between the femoral axis and a perpendicular line); FSX femoral
distance (distance from the center of femoral head to the distal femur on FSX); WBX
intersection length (length between the center of the femoral head and the intersection
point [the point at which the line connecting the center of the femoral head and the
midpoint of the femoral condyle intersects the center line of the femur] on WBX).
Results
The WBX femoral angle, and FSX femoral angle were 0.16 ± 4.2°, and −0.53 ± 4.1°, respectively.
The FSX femoral distance was 102.7 ± 41.1 mm. An ROC curve analysis revealed that
the cut-off value of the FSX femoral distance associated with minimal difference in
the WBX and FSX femoral angles (<3°) was 73 mm (sensitivity 83.3%, specificity 87.5%,
AUC 0.80). The WBX intersection length was 105.3 ± 27.3 mm.
Conclusion
To calculate the femoral angle on FSX that approximates the WBX femoral angle, the
femoral distance on FSX ≥73 mm is preferable. We suggest using the FSX femoral distance
within the range of 80 mm–130 mm as a simple numerical value that meets all criteria.
Keywords
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Article info
Publication history
Published online: March 01, 2023
Accepted:
February 12,
2023
Received in revised form:
January 30,
2023
Received:
July 20,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
