• Physical Therapy Korea
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• v.19 no.4
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• pp.55-60
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• 2012

The trochanteric prominence angle test (TPAT) has been used to measure the femoral anteversion angle between the tibial crest and the vertical line. However, the exact anatomical reference of the tibial crest has not yet been identified in the literature. Thus, the purposes of this research were twofold: first, to compare the femoral anteversion angle measured at three different anatomical references of the tibial crest (the proximal tibial crest, the proximal third of tibial crest, and the proximal half of tibial crest) and, second, to determine inter-and intra-rater reliabilities of the femoral anteversion angle measured at these three different anatomical references of the tibial crest during the TPAT. We recruited 14 healthy subjects, and a total of 28 legs were examined. The TPAT was measured using a digital inclinometer. A 1-way repeated-measure analysis of variance was used to compare the femoral anteversion angle measured at three different anatomical references of the tibial crest, and intraclass correlation coefficients (ICCs) were calculated to determine reliability. The femoral anteversion angle measured at the proximal tibial crest was significantly higher than that at the proximal third of the tibial crest and the proximal half of the tibial crest. The inter-and intra-rater reliabilities of femoral anteversion angle were measured at three anatomic references of the tibial crest were all found to be high during the TPAT (ICC=.9 0~.98). In conclusion, clinicians should recognize that the different degrees of the femoral anteversion angle could be measured when different anatomical references of the tibial crest were used, and that reliabilities were high when an exact anatomical reference of the tibial crest was used during the TPAT.

• Journal of the Ergonomics Society of Korea
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• v.20 no.3
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• pp.27-35
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• 2001

The measurement of the fermoral anteversion is an important factor in the practice of orthopedic surgery. The anteversion is measured by means of the axis of head and neck of the femur. In this study. widely used computed tomography method of measuring anteversion was tested on femoral necks of patients. Measurement by the manual method and image viewer of computed tomography to determine the anteversion of femoral head were carried out on both femurs. In January and February 2001, 30 patients 3 to 6 years of age were randomly selected from Seoul National University Hospital. the purpose of this paper was to introduce a new method to measure femoral anteversion angle utilizing image viewer program. This new method was more accurate and convenient than the conventional manual method. No significant difference was observed between the manual method and the image viewer measurement of femoral anteversion. In conclusion, image viewer program was statistically more reliable in determining the angle of the fermoral anteversion.

• Physical Therapy Korea
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• v.13 no.4
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• pp.1-9
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• 2006

The purpose of this research was to analyze the effects of the increase of the femoral anteversion angle on the unbalanced quadriceps femoris muscle causing the increase of the valgus force on the knee joints and patellofemoral pain syndrome by comparing with the group that shows the smaller femoral anteversion angle. The method for the research was to compare the femoral muscle's activity while the subjects were maintaining the knee joint flexed isometrically for 10 seconds. The evaluation tool for femoral muscle's activity was QEMG-4 (model LXM 3204). The results were as followings. Firstly, in case of the experimental group, the muscle strength of the vastus lateralis muscle was strong while the rectus femoris and vastus medialis were weak. In these facts, we can see the statistically meaningful difference in vastus medialis muscle activity. Secondly, in the muscle activity analysis for vastus lateralis and medialis of the two groups, we could see the vastus lateralis muscle was strong in anteversion wider for experimental group while the vastus medialis muscle contracted far more stronger in anteversion smaller for control group. From these results, we can see the significant differences in muscle recruitment between the two groups. Above results show that if the anteversion becomes wider, vastus medialis muscle will become seriously weaker, on the other hand, vastus lateralis act stronger.

• Journal of Veterinary Clinics
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• v.33 no.6
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• pp.340-345
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• 2016

The present study determined the normal reference ranges for the femoral and tibial joint orientation angles of small-breed dogs. For this purpose, 60 each of cadaveric canine femurs and tibias from normal small-breed dogs (Maltese, Poodle, Shih Tzu, Yorkshire Terrier) were examined with radiographs and photographs. Axial and frontal radiographs and photographs of each bone were obtained, from which anteversion and inclination angles, anatomic lateral proximal and distal femoral angles (aLPFA and aLDFA), mechanical lateral proximal and distal femoral angles (mLPFA and mLDFA), and mechanical medial proximal and distal tibial angles (mMPTA and mMDTA) were measured. The 95% CI for radiographic values of all femurs and tibiae were anteversion angle, $23.4-27.4^{\circ}$; inclination angle, $128.4-130.4^{\circ}$; aLPFA, $117.8-122.1^{\circ}$; aLDFA, $93.7-95.2^{\circ}$; mLPFA $113.8-117.3^{\circ}$; mLDFA $99.2-100.5^{\circ}$; mMPTA $96.8-98.5^{\circ}$; mMDTA $89.4-90.7^{\circ}$. The Maltese had a larger anteversion angle than the Poodle and the Yorkshire Terrier and a larger mLPFA than the Poodle. In the comparison between the radiographs and the photographs, significant differences were found in the anteversion angle, mLPFA, mMPTA, and mMDTA. The established normal reference values might be useful for determining whether a valgus or varus deformity of the femur or the tibia is present and if so, the degree of angular correction needed.

• Journal of radiological science and technology
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• v.26 no.1
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• pp.83-89
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• 2003

The accurate measurement of the femoral anteversion is very important to the practice of orthopedic and osteotomy. It is measured by means of the axis of head and neck of the femur and the knee axis. At the present time, widely used computed tomography method of measuring anteversion on femoral necks of patients. Measurement by the manual method and image viewer of computed tomography to determine the anteversion of femoral head were carried out on both femurs. In September and October 2002, 5 patients 28 to 36 years of age were randomly selected from Seoul National University Hospital. The purpose of this paper was to introduce a new method to measure femoral anteversion angle utilizing PACS image viewer program in the MR imaging. Significant difference was observed between the right and left side the image viewer measurement of femoral anteversion. In conclusion, MR imaging very usefulness in the measured the angle of the femoral anteversion.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.05
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• pp.141-144
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• 1997

Femoral neck anteversion is the angle between the neck and the knee axis projected on a plane perpendicular to the longitudinal axis. Conventional methods that use cross-sectional Computed Tomography(CT) images to estimate femoral anteversion have several problems because of the complex 3D structure of the femur. These are the ambiguity of defining the longitudinal axis, the femoral neck axis and condylar line, and the dependence on patient positioning. Especially the femoral neck axis that is known as a major source of error is hard to determine from a single or multiple 2D transverse images. So we developed a new method for measuring femoral anteversion by 3D modeling method. In this method, femoral head is modeled as a sphere. The center of femoral neck is the mid-point of the 2D reconstructed oblique image in the femoral neck part. Then neck axis is a line connecting foregoing two centers. We model the longitude of femur as a cylinder, and the long axis is defined from the fitted cylinder. The knee axis which is tangent to the back of the femoral condyles is easily determined by table-top method. By the definition of femoral anteversion, the femoral anteversion is easily calculated from this model.

• Journal of Veterinary Clinics
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• v.37 no.4
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• pp.180-184
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• 2020

The purpose of this study was to report the reliability and validity of oblique single-cut rotation osteotomy (OSCRO) in 3D-reconstructed canine bone models with femoral varus and torsional deformities. A healthy adult male beagle was recruited to create a 3D bone model, and this bone model was modified by using a 3D program. Fifteen bone models were constructed for this study. OSCRO simulation was performed in accordance with the plan after printing using a 3D printing machine. The anatomical lateral distal femoral angle (aLDFA), anteversion angle (AA), anatomical caudo-distal femoral angle (aCdDFA), mechanical caudo-distal femoral angle (mCdDFA) and pre- and postoperative bone length were calculated. There were no significant differences between the target values and postoperative values. In addition, the difference between pre- and postoperative bone length was small (p = 0.001). Our findings suggest that OSCRO could be an effective surgical option for MPL with bone deformities in small-breed dogs that often undergo conventional distal femoral osteotomy.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.420-426
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• 2018

Background: The tibial tuberosity-trochlear groove (TT-TG) distance is used to determine the necessity of tibial tubercle osteotomy. We conducted this study to determine the extent to which each of the tibial tuberosity lateralization, trochlear groove medialization, and knee rotation angle affects the TT-TG distance in both normal and patella dislocated patients and thereby scrutinize the rationale for tuberosity transfer based on the TT-TG distance. Methods: Retrospective analysis of rotational profile computed tomography was done for patella dislocated and control group patients. Femoral anteversion, tibial torsion, knee rotation angle, tuberosity lateralization, and trochlear groove medialization were assessed in all patients. Relationship of these parameters with the TT-TG distance was investigated to evaluate their effects on the TT-TG distance. Results: We observed that the patellar dislocation group, compared to the control group, had increased TT-TG distance (mean, 19.05 mm vs. 9.02 mm) and greater tuberosity lateralization (mean, 64.1% vs. 60.7%) and tibial external rotation in relation to the femur (mean, $7.9^{\circ}$ vs. $-0.81^{\circ}$). Conclusions: Tuberosity lateralization and knee rotation were factors affecting patellar dislocation. These factors should be considered in addition to the TT-TG distance to determine the need for tibial tubercle osteotomy in patients with patellar dislocation.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.134-141
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• 2021

Purpose: Patellar dislocations have a range of causes. This study examined the results of treatment aimed at balancing soft tissues around the patella. Materials and Methods: Thirty-two patellar dislocations in 28 patients (21 females and seven males) were examined. The mean patient age at the time of surgery was 11.5 years, and the mean follow-up period was 4.6 years. Dislocations were 19 chronic, six habitual, six congenital, and one acute. Soft tissue balancing surgery included lateral capsular release, medial capsular plication, and inferolateral transfer of the vastus medialis obliquus. Medial transfer of the patellar tendon, partial strip of the rectus femoris and patella tendon, and distal femoral osteotomy were also performed selectively. The preoperative Q angle, femoral anteversion angle, tibial external rotation angle, tibial tubercle-trochlear groove distance (TT-TG distance), mechanical femoral-tibial angle, and femoral trochlear dysplasia according to Dejour were measured, and the pre- and postoperative Lysholm-Tegner scores were used to analyze the clinical results. Results: The mean preoperative Q angle, TT-TG distance, femoral anteversion angle, tibial external rotation angle, mechanical femoraltibia angle, and Lysholm-Tegner score were 9.3°, 15.5 mm, 25.6°, 30.4°, 3.0°, and 75.8, respectively. Eleven patients had systemic ligament laxity with a Beighton score of five or more. Twenty-two patients had femoral trochlear dysplasia: four type A (3 patients), 16 type B (15 patients), one type C (1 patient), and four type D (3 patients). Of the 32 cases, 28 were corrected successfully by the first operation. Of four cases of postoperative subluxation, three were corrected by the second operation, and one of them was corrected after a third operation. The last patient is currently being followed-up. The mean Lysholm-Tegner score improved to 85.6 after the operation. Conclusion: Correcting all the causes of patella dislocation simultaneously is difficult. Nevertheless, satisfactory outcomes were obtained with soft tissue balancing surgery around the patella and a corrective osteotomy for an abnormal mechanical axis of the femur-tibia and torsion.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.490-497
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• 2018

Purpose: To evaluate the utility of ceramic-on-polyethylene articular bearing surface when cementless total hip arthroplasty is performed in patients older than 65 years through an analysis of the minimum five-year follow-up results using the ceramic femoral head and cross-linked polyethylene liner. Materials and Methods: From March 2010 to September 2012, 51 patients (56 hips) who were older than 65 years were enrolled in this retrospective study. The mean age at surgery was $70.9{\pm}5.1years$ old. A clinical assessment was analyzed using the Harris hip score. For the radiographic assessment, the cup inclination and anteversion, stem alignment, and wear amount were measured. The postoperative complications were also determined. Results: The mean Harris hip score was improved from preoperative 48 points to postoperative 87 points (p<0.05). The mean cup inclination was $40.9^{\circ}{\pm}6.4^{\circ}$ and the mean cup anteversion was $20.3^{\circ}{\pm}8.1^{\circ}$. The mean cup anteversion of the elevated liner-used group (16 cases) was $14.3^{\circ}{\pm}7.9^{\circ}$ and the mean cup anteversion of the neutral liner used group (40 cases) was $22.4^{\circ}{\pm}9.1^{\circ}$ (p<0.05). The mean stem alignment angle was $0^{\circ}$ (range, varus $4^{\circ}$-valgus $4^{\circ}$). The mean linear wear amount was $0.458{\pm}0.041mm$ and the average annual linear wear rate was $0.079{\pm}0.032mm/yr$. Six cases (10.7%) of intraoperative periprosthetic femoral fractures were encountered. Conclusion: Based on these results, the use of a ceramic-on-polyethylene articular bearing surface in elderly patients with cementless total hip arthroplasty is beneficial. On the other hand, careful effort is needed to prevent intraoperative periprosthetic femoral fractures.