Goniometric measurements explained approximately 20% of the variation in lower limb alignment as measured by whole limb radiography suggesting that simple clinical measures of lower limb alignment contain too much error for inferring actual lower limb alignment. Associations between goniometric measures and whole limb radiographs was moderate (r= 0.43 for right knee and r=0.46 for left knee). Diagnostic validity was examined using data from 1,390 persons with symptomatic knee OA, based on comparison to tibiofemoral joint space narrowing obtained from standardized radiographs. Data from 142 persons with symptomatic knee OA were used to examine concurrent validity, based on comparison to whole limb radiographs. Data from the Osteoarthritis Initiative were used to assess concurrent and diagnostic validity of goniometric measures. The purpose of this study was to assess the validity of goniometric measures of frontal plan knee position as a simple clinical tool to assess lower limb alignment and tibiofemoral OA status. However, there is little data to indicate whether simple to obtain clinical measures frontal plane alignment indicate the actual bony alignment of the knee or the extent and type of knee osteoarthritis. Clinicians frequently assess frontal plane knee alignment of patients suspected of having knee osteoarthritis.
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