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Effects of Thigh and Leg Rotation on Sagittal Knee Angle During Static Assessment.

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Concurrent Validity of Three Photogrammetric Methods for Assessing Knee Alignment in Sagittal Plane.

Bruna Nichele da Rosa¹, Paula Andryelly Gomes Giendruczak¹, Marina Ziegler Frantz¹

¹Physical Education Department, Federal University of Rio Grande do Sul, Porto Alegre 90010-150, Brazil.

Methods and Protocols

|April 25, 2025

Summary

Photogrammetry can accurately measure knee alignment, especially when accounting for limb rotations. This study validates photogrammetric methods for lower limb analysis, highlighting the importance of rotational correction for precision.

Keywords:

knee photogrammetry posture reproducibility of tests

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Area of Science:

Biomechanics
Medical Imaging
Orthopedics

Background:

Limited evidence exists for photogrammetry's validity in assessing body segment alignment beyond the spine.
Research on photogrammetric use for lower limb alignment, particularly knee alignment, is scarce.
Existing studies predominantly focus on spinal evaluation, necessitating further investigation into other body segments.

Purpose of the Study:

To evaluate the concurrent validity of three photogrammetric methods for measuring knee alignment in the sagittal plane.
To assess the impact of correcting for thigh and leg rotational deviations on measurement accuracy.
To compare the effectiveness of different photogrammetric techniques in assessing knee alignment.

Main Methods:

Concurrent validity was assessed by comparing photogrammetry with panoramic radiography in 21 adults.
Three photogrammetric methods were used: condylar angle (CA), fibula head angle (FHA), and four-point angle (4PA).
Measurements were taken with raw and corrected values, accounting for thigh and leg rotations.

Main Results:

Correcting for thigh and leg rotations significantly improved the validity metrics for all photogrammetric methods.
The corrected condylar angle (CAcorr) showed the best performance (r = 0.746, RMSE = 2.9°).
The corrected four-point angle (4PAcorr) also demonstrated strong validity (r = 0.733, RMSE = 3.0°), though proportional errors were noted.

Conclusions:

The evaluated photogrammetric methods are validated for assessing sagittal knee alignment.
Accounting for thigh and leg rotational deviations is crucial for accurate knee alignment measurements.
Further development of tools for precise measurement of lower limb rotations is needed to enhance accuracy and avoid errors.