Abstract
IntroductionThis study compared the feasibility of six different CT-based measurement techniques for establishing an indication for derotational osteotomy in the cases of patellar instability or femoral fracture.Materials and methodsCT scans of 52 single human cadaver femora were measured using six different torsion measurement techniques (described by Waidelich, Murphy, and Yoshioka on transverse images and Hernandez, Jarrett, and Yoshioka on oblique images). All measurements were performed by four observers twice to assess intraobserver and interobserver agreement. The intraclass correlation coefficient (ICC), ANOVA, and Bonferroni post hoc test were used for the statistical analysis.ResultsSignificant differences (P < 0.001) between the values for femoral torsion were observed with all techniques except Yoshioka’s techniques on transverse and oblique slices (P = 1.000) (transverse images: Waidelich 22.4° ± 6.8°, Murphy 17.5° ± 7.0°, Yoshioka 13.4° ± 6.9°; oblique images: Hernandez 11.4° ± 7.4°, Jarrett 14.9° ± 7.5°, Yoshioka oblique 13.4° ± 7.1°). Intraobserver and interobserver agreement showed a high level of reproducibility (ICC 0.877–0.986; mean 0.8°–2.9°) for all techniques, with the greatest difference being observed with Hernandez’s technique (11.4°/10°).ConclusionsFemoral torsion values depend on the measurement technique. When derotational osteotomy is being considered, it is essential to use different threshold values depending on the measurement technique.
Highlights
Introduction This study compared the feasibility of six different computed tomography (CT)-based measurement techniques for establishing an indication for derotational osteotomy in the cases of patellar instability or femoral fracture
Significant differences were observed between pairwise comparisons of the techniques in the values measured for femoral torsion (P \ 0.001), with the exception of Yoshioka’s technique on transverse and oblique slices (P = 1.000)
The most important finding of the present study was that the values measured for femoral torsion showed significant differences (P \ 0.001) among the measurement
Summary
This study compared the feasibility of six different CT-based measurement techniques for establishing an indication for derotational osteotomy in the cases of patellar instability or femoral fracture. Materials and methods CT scans of 52 single human cadaver femora were measured using six different torsion measurement techniques (described by Waidelich, Murphy, and Yoshioka on transverse images and Hernandez, Jarrett, and Yoshioka on oblique images). All measurements were performed by four observers twice to assess intraobserver and interobserver agreement. Results Significant differences (P \ 0.001) between the values for femoral torsion were observed with all techniques except Yoshioka’s techniques on transverse and oblique slices (P = 1.000) (transverse images: Waidelich 22.4° ± 6.8°, Murphy 17.5° ± 7.0°, Yoshioka 13.4° ± 6.9°; oblique images: Hernandez 11.4° ± 7.4°, Jarrett 14.9° ± 7.5°, Yoshioka oblique 13.4° ± 7.1°). Intraobserver and interobserver agreement showed a high level of reproducibility (ICC 0.877–0.986; mean 0.8°–2.9°) for all techniques, with the greatest difference being observed with Hernandez’s technique (11.4°/10°).
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