A Validated, Automated, 3-Dimensional Method to Reliably Measure Tibial Torsion.
Background: Tibial torsion is a twist in the tibia measured as an angle between a proximal axis line and a distal axis line. Abnormal torsion has been associated with a variety of painful clinical syndromes of the lower limb. Measurements of normal tibial torsion reported by different authors vary b...
| Published in: | American Journal of Sports Medicine Vol. 49; no. 3; pp. 747 - 757 |
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| Main Authors: | , , , , |
| Format: | diagnostic images pictorial research tables/charts Journal Article |
| Published: |
Sage Publications Inc.
Mar2021
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148979031&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148979031 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03635465 ASM jtl: American Journal of Sports Medicine issn: 03635465 maglogo: Y pubinfo: dt: Mar2021 vid: 49 iid: 3 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 148979031 148466021 148979031 148979031 10.1177/0363546520986873 148979031 ppf: 747 ppct: 10 formats: tig: atl: A Validated, Automated, 3-Dimensional Method to Reliably Measure Tibial Torsion. aug: au: Stephen, Joanna M. Teitge, Robert A. Williams, Andy Calder, James D.F. El Daou, Hadi affil: Department of Mechanical Engineering, Imperial College London, London, UK sug: subj: Tibia Pathology Torsion Abnormality Imaging, Three-Dimensional Human Reliability Tomography, X-Ray Computed Magnetic Resonance Imaging Male Female Descriptive Statistics Adolescence Adult Middle Age Aged Intraclass Correlation Coefficient Cadaver Scanners Comparative Studies T-Tests Data Analysis Software Intrarater Reliability Interrater Reliability Software Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Tibial torsion is a twist in the tibia measured as an angle between a proximal axis line and a distal axis line. Abnormal torsion has been associated with a variety of painful clinical syndromes of the lower limb. Measurements of normal tibial torsion reported by different authors vary by 100% (ranging from 20° to 42°), making it impossible to determine normal and pathological levels. Purpose: To address the problem of unreliable measurements, this study was conducted to define an automated, validated computer method to calculate tibial torsion. Reliability was compared with current clinical methods. The difference between measurements of torsion generated from computed tomography (CT) and magnetic resonance imaging (MRI) scans of the same bone, and between males and females, was assessed. Study Design: Controlled laboratory study. Methods: Previous methods of analyzing tibial torsion were reviewed, and limitations were identified. An automated measurement method to address these limitations was defined. A total of 56 cadaveric and patient tibiae (mean ± SD age, 37 ± 15 years; range, 17-71 years; 28 female) underwent CT scanning, and 3 blinded assessors made torsion measurements by applying 2 current clinical methods and the automated method defined in the present article. Intraclass correlation coefficient (ICC) values were calculated. Further, 12 cadaveric tibiae were scanned by MRI, stripped of tissue, and measured using a structured light (SL) scanner. Differences between torsion values obtained from CT, SL, and MRI scans, and between males and females, were compared using t tests. SPSS was used for all statistical analysis. Results: When the automated method was used, the tibiae had a mean external torsion of 29°± 11° (range, 9°-65). Automated torsion assessment had excellent reliability (ICC, 1), whereas current methods had good reliability (ICC, 0.78-0.81). No significant difference was found between the torsion values calculated from SL and CT (P =.802), SL and MRI (P =.708), or MRI and CT scans (P =.826). Conclusion: The use of software to automatically perform measurements ensures consistency, time efficiency, validity, and accuracy not possible with manual measurements, which are dependent on assessor experience. Clinical Relevance: We recommend that this method be adopted in clinical practice to establish databases of normal and pathological tibial torsion reference values and ultimately guide management of related conditions. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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