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. 2018 Aug 22;5(1):32.
doi: 10.1186/s40634-018-0147-3.

Contribution of sex and body constitution to three-dimensional lower extremity alignment for healthy, elderly, non-obese humans in a Japanese population

Ryota Katsumi  1 , Tomoharu Mochizuki  2 , Takashi Sato  1 , Koichi Kobayashi  3 , Satoshi Watanabe  1 , Osamu Tanifuji  4 , Naoto Endo  4
Affiliations

Contribution of sex and body constitution to three-dimensional lower extremity alignment for healthy, elderly, non-obese humans in a Japanese population

Ryota Katsumi et al. J Exp Orthop. .

Abstract

Background: Humans support their bodies exclusively by vertical balance in bipedal locomotion, and the body, especially the lower extremity, generally changes with age. Sex and body constitution are assumed to be associated with lower extremity alignment, but this association remains to be elucidated. This study sought to clarify this association in healthy, elderly, non-obese humans in a Japanese population.

Methods: The present study investigated 55 healthy volunteers (mean age: 70 ± 6 years). A 3D extremity alignment system was applied under weight-bearing conditions on biplane long lower extremities X-rays using a 3D-to-2D image registration technique. The evaluation parameters included 3D hip-knee-ankle angle (3DHKA) alignment in the coronal (coronal alignment) and sagittal planes (sagittal alignment) and rotational alignment between the femur and tibia. The influences of sex and body constitution on all the alignment were analyzed.

Results: Multiple linear regression analysis with the dependent variable of each alignment showed that sex was the dominant factor for coronal and rotational alignment (coronal: p < 0.01; rotational: p < 0.01), and body weight was the dominant factor for sagittal alignment (p < 0.01).

Conclusions: The association of sex with coronal and rotational alignment and of body constitution with sagittal alignment were proved in healthy, elderly, non-obese humans in a Japanese population. This finding can lead to further understanding of the etiology of many diseases and age-related changes.

Keywords: Body constitution; Healthy elderly human; Lower extremity alignment; Sex.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Institutional Review Board in Niigata Medical Center. Appropriate consents, permissions and releases were obtained.

Consent for publication

All presentations had consent to publish.

Competing interests

The authors did not receive and will not receive any benefits or funding from any commercial party related directly or indirectly to the subject of this article.

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Figures

Fig. 1
Fig. 1
Schematic illustration of femoral and tibial coordinate system
Fig. 2
Fig. 2
Schematic illustration of the three-dimensional (3D) to two-dimensional (2D) image registration technique. For the biplanar radiography images, the subjects stood at 0° (a) and 60° (b) to cassette holder. The 3D digital bone models were projected onto the biplanar radiography images in the weight-bearing conditions, using the three-dimensional (3D) to two-dimensional (2D) image registration technique
Fig. 3
Fig. 3
Schematic illustration of coronal and sagittal alignment in a three dimensional space
Fig. 4
Fig. 4
Schematic illustration of rotational alignment in a three dimensional space
Fig. 5
Fig. 5
Representative images showing the difference between men (a) and women (b)
See this image and copyright information in PMC

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