Use of anthropometry for the measurement of lower extremity alignment

Abstract

The measurement of lower extremity alignment is an important component of the diagnosis and prognosis of musculoskeletal diseases. In addition, poor lower extremity alignment has been identified as a risk factor for incurring injuries during physical activities. Relating anthropometric information and limb alignment to joint loads during daily activities enables the identification of risk factors for musculoskeletal injuries and diseases. Lower extremity alignment can be assessed directly using medical imaging techniques or indirectly using established clinical measures. Palpation of anatomical landmarks and anthropometric information is currently used for many indirect methods assessing the alignment of the lower extremity. Current clinical methods for the measurement of lower extremity alignment include visual observation and methods using callipers, inclinometers or goniometers. A recent study showed the potential of using position capture similar to what is typically performed during gait analysis as an alternative method for the assessment of lower extremity alignment. Mechanical axis alignment assessed using this method correlated with radiographic measurements, the current gold standard, and with disease severity in patients with medial compartment knee osteoarthritis (OA). In addition, novel technology including functional joint center determination and markerless motion capture has a great potential in providing objective and thus reliable assessments of lower extremity alignment especially in populations that would not routinely undergo radiographic examination. Indirect assessment of lower extremity alignment can be challenging in obese patients and in the elderly. Establishing relationships between anthropometric information, limb alignment and detailed information measured using novel techniques is an important step in increasing the relevance of simple and quick clinical measurements for a larger range of sub-populations in health and disease.