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Osteoarthritis Cartilage. 2004 Mar;12(3):256-9.

A new computer-assisted method for measuring the tibio-femoral angle in patients with osteoarthritis of the knee.

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Department of Orthopaedics, Kochi Medical School, Oko-cho, Nankoku, Kochi, 783-8505, Japan.



The purpose of this study was to evaluate the inter- and intraobserver variability in measuring the tibio-femoral angle using our new computer-assisted method, and to compare it with a conventional manual method.


Radiography of all patients of osteoarthritis of the knee in outpatient were performed with standing on both legs, and with conventional antero-posterior weight bearing view of the knee fully extended. Three examiners measured the tibio-femoral angle with the computerized method in 52 subjects with osteoarthritis (73 knees). The tibio-femoral angle was measured using a computer-assisted method in which the observer must visually determine and select eight points on the margins of the femur and tibia on a radiographic image displayed on a computer monitor. The inter- and intraobserver Intra-class correlation (ICC) was analyzed.


The interobserver mean correlation of computer-assisted method was 0.970 with a mean difference of 0.38 degrees (S.D. 1.125 degrees). The intraobserver mean ICC of computer-assisted method was 0.973, with a mean difference of 0.16 degrees (S.D. 1.12 degrees). An analysis of the difference between conventional methods and our new system showed a mean ICC of 0.922, with an intersystem mean difference of 0.295 degrees (S.D. 1.82 degrees).


Our computer-assisted method of measuring the tibio-femoral angle was simple, easy, and quick, and should be considered as an alternate method for measurement.

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