Rotational alignment of the lower limb in osteoarthritis of the knee


Rotational alignement of the lower limbs in 43 patients with osteoarthritis of the knee was measured by computerized tomography. Eighty-four limbs were classified in three subsets, patellofemoral osteoarthritis (subset P), medial femorotibial osteoarthritis (subset M) and lateral femorotibial osteoarthritis (subset L). The femorotibial angle of subset M was 5° greater than that of subset P on the average. Femoral torsion of subset P was significantly greater than that of subset M. Femoral torsion in osteoarthritis of the knee was correlated with external tibial torsion and external torsion of the leg, which included both external rotation at the knee and external tibial torision. External torsion of the leg in subset M was less than normal and rotational alignment of subset P was also outside the normal range. Our findings show that the frontal and rotational alignment of the lower limb are aetiological factors in osteoarthritis of the knee.


Nous avons mesuré par tomodensitographie l'alignement en rotation des membres inférieurs chez 43 malades atteints de gonarthrose. Les quatre-vingt-quatre membres ont été classés en trois sous-groupes: arthrose fémoro-patellaire (sous-groupe P), arthrose fémoro-tibiale interne (sous-groupe M) et arthrose fémoro-tibiale externe (sous-groupe L). L'angle fémoro-tibial du sous-groupe M était supérieur de 5° en moyenne à celui du sous-groupe P. La torsion fémorale du sous-groupe P était significativement plus importante que celle du sous-groupe M. La torsion fémorale dans la gonarthrose a été corrélée à la torsion tibiale externe et à la torsion externe de la jambe qui associe la rotation externe du genou et la torsion tibiale externe. La torsion externe de la jambe dans le sous-groupe M était inférieure à la normale et l'alignement en rotation du sous-groupe P était également en dehors des limites de la normale. Nos résultats montrent que l'alignement frontal et l'alignement en rotation du membre inférieur jouent un rôle dans l'étiologie de la gonarthrose.

This is a preview of subscription content, access via your institution.


  1. 1

    Ahlbäck S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol [Suppl]: 277

  2. 2

    Bauer GCH, Insall J, Koshino T (1969) Tibial osteotomy in gonarthrosis. J Bone Joint Surg. 51-A: 1545–1563

    Google Scholar 

  3. 3

    Hutter CG, Scott W (1949) Tibial torsion. J Bone Joint Surg 31-A: 511–518

    Google Scholar 

  4. 4

    Insall J, Falvo KA, Wise DW (1976) Chondromalacia patellae, a prospective study. J Bone Joint Surg 58-A: 1–8

    Google Scholar 

  5. 5

    Insall J (1979) Chondromalacia patellae, malalignment syndrome. Orthop Clin North Am 10: 117–127

    Google Scholar 

  6. 6

    Ise N (1976) Torsion of the lower extremity. (In Japanese with English summary) J Jpn Orthop Assoc 50: 157–168

    Google Scholar 

  7. 7

    Jackson JP, Waugh W (1961) Tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg 43-B: 746–751

    Google Scholar 

  8. 8

    Kite JH (1954) Torsion of the lower extremity in small children. J Bone Joint Surg 36-A: 511–520

    Google Scholar 

  9. 9

    Nachlas W (1934) Medial torsion of the leg. Arch Surg 28: 909–919

    Google Scholar 

  10. 10

    Somerville EW (1957) Persistent foetal alignment of the hip. J Bone Joint Surg 39-B: 106–113

    Google Scholar 

  11. 11

    Soutter R, Bradford EH (1903) Twists in normal and in congenitally dislocated femora. NY Med J Phila Med J 78: 1071–1077

    Google Scholar 

  12. 12

    Staheli LT, Engel GM (1972) Tibial torsion. A new method of assessment and a survey of normal children. Clin Orthop 86: 183–186

    Google Scholar 

  13. 13

    Wynne-Davies R (1964) Talipes equinovarus. J Bone Joint Surg 46-B: 464–476

    Google Scholar 

  14. 14

    Yagi T (1984) A study on torsion of the lower leg in osteoarthritis of the knee. (In Japanese with English summary). J Jpn Orthop Assoc 36: 405–417

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to S. Takai.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Takai, S., Sakakida, K., Yamashita, F. et al. Rotational alignment of the lower limb in osteoarthritis of the knee. International Orthopaedics 9, 209–215 (1985).

Download citation

Key words

  • Osteoarthritis of the knee
  • Rotational alignment of the lower limb
  • Computerized tomography