Olmedo-Buenrostro BA, Díaz-Giner V, Jiménez-Herrera C, Valadez-Meneses R, Trujillo-Hernández B, Huerta M, Trujillo X, Mora-Brambila AB, Tene-Pérez CE, Vásquez C

Language: Spanish
References: 12
Page: 26-32
PDF size: 179.36 Kb.

ABSTRACT

Objective. To identify the existence of significant differences in the degrees of mal-alignment of the mechanical axis of the knee between a traditional measuring method and an alternative method. Materials and methods. One hundred mechanical axes of the knee were determined in patients of both sexes. The degree of axis mal-alignment was obtained first using the traditional measuring method and subsequently using the alternative method. The results obtained from the two methods were then compared. The measurement variable control was standardised by positioning the patients in the same place during radiography when beginning mechanical axis determination. A wooden ruler on which each centimetre was indicated by a metal strip and numbered at every 10-centimeter interval was used to evaluate the degree of pelvic mal-alignment. The ruler was then used as a mechanical axis correction reference in accordance with the characteristics of each patient. Results. The following results were obtained from 100 mechanical axes evaluated by the traditional method and by the alternative method, respectively: varus deformity of the right pelvic segment was 21° ± 16° vs. 7 ± 6°; varus deformity of the left pelvic segment was 22 ± 17° vs. 8 ± 5°; valgus deformity of the right pelvic segment was 21 ± 15° vs. 8 ± 6; and valgus deformity of the left pelvic segment was 16 ± 11 vs. 6 ± 5°. Conclusions. Our results suggest that the proposed method provides more accurate mechanical axis measurement and that the correction is exponential: the greater the angle measured traditionally, the greater the correction with our proposed method.

REFERENCES

1. Muñoz-Gutiérrez J. Relaciones axiales de las extremidades pélvicas. En: Muñoz-Gutiérrez J (ed.). Atlas de Mediciones Radiográficas en Ortopedia y Traumatología. Distrito Federal, México: McGraw Hill Interamericana; 1999, p. 325-32.

2. Viladot A. Biomecánica de la extremidad. Ortesis y prótesis del aparato locomotor inferior. En: Viladot R, Cohl O, Clavell S (eds.). Barcelona, España: Masson; 1987, p. 25-7.

3. McCormak D. Mechanical axis deviation: definitions: definitions, measurements and consequences. Irish Journal of orthopaedics and trauma surgery 1999; 2: 1-9. Disponible en: www.iol ie/~rcsiorth/journal/volume2/issue5/mech.htm [Consultado el 18 de noviembre de 2007].

4. Kraus VB, Vail TP, Worrell T, McDaniel G. A comparative assessment of alignment angle of the knee by radiographic and physical methods. Arthritis Reum 2005; 52: 1730-5.

5. Hinman RS, May RL, Crossley KM. Is there and alternative to the full-leg radiograph for determining knee joint alignment in osteoarthritis? Arthritis Reum 2006; 55: 306-13.

6. Sailer J, Scharitzer M, Peloschek P, Giurea A, Imhof H, Grampp S. Quantification of axial alignment of the lower extremity on conventional and digital total leg radiographs. Eur Radiol 2005; 15: 170-3.

7. Goker B, Block JA. Improved precision in quantifying knee alignment angle. Clin Orthop Relat Res 2007. Disponible en: b lib.bioinfo.pl/pmid:17259895 [Consultado el 25 de enero de 2007].

8. Moreland JR, Bassett LW, Hanker GJ. Radiographic analisis of the axial aligment of the lower extremity. J Bone Joint Surg Am 1987; 69: 745-9.

9. Herrera DH, Bernal FG, Sánchez GL. Eje mecánico radiográfico: su utilidad en las correcciones axiales de la rodilla en el plano frontal de causa tibial. An Ortop y Traumat 1977; 13: 223.

10. Pauwels F. Biomechanics of the normal locomotor apparatus. New York, Springer Velag; 1980.

11. Tang WM, Zhu YH, Chiu KY. Axial alignment of the lower extremity in Chinese adults. J Bone Joint Surg Am 2000; 82: 1603-8.

12. Hsu RWW, Himeno S, Coventry MB, Chao EYS. Normal axial aligment of the lower extremity and load bearing distribution at the knee. Clin Orthop Rel Research 1990; 255: 215-17.