{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T14:57:40Z","timestamp":1784905060659,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":57,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The hip\u2010knee\u2010ankle angle is a crucial parameter in orthopaedic surgery for lower limb assessment. However, traditional methods for measuring the hip\u2010knee\u2010ankle angle on standing long\u2010leg anteroposterior radiographs are time\u2010consuming, require significant expertise and lack reproducibility. Given the emergence of artificial intelligence as a promising tool to automate these measurements, this study aimed to assess the accuracy of Gleamer BoneMetrics for hip\u2010knee\u2010ankle angle measurement and its correlation with assessments by experienced orthopaedic surgeons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 75 patients who underwent knee arthroplasty between October 2023 and June 2024 were included. Preoperative and postoperative long\u2010leg anteroposterior radiographs were analysed both by two experienced orthopaedic surgeons who manually measured the hip\u2010knee\u2010ankle angle and by the Gleamer BoneMetrics software; the analyses were tested for both inter\u2010 and intra\u2010rater reliability. Statistical analysis was performed using intraclass correlation coefficients and Bland\u2010Altman plots to assess the correlation between the Gleamer BoneMetrics and the human raters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The Gleamer BoneMetrics demonstrated excellent inter\u2010 and intra\u2010rater reliability, with intraclass correlation coefficient values ranging from 0.995 to 0.998, which were comparable to the surgeons' measurements of 0.997\u20130.998. The Gleamer BoneMetrics's intra\u2010rater reliability was also excellent, with intraclass correlation coefficient values of 1.0 preoperatively and 0.996 postoperatively. Bland\u2013Altman analysis showed minimal measurement discrepancies between Gleamer BoneMetrics and the human raters. However, in 2% of the cases (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), Gleamer BoneMetrics was not able to provide measurements.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The artificial intelligence\u2010based BoneMetrics software offers an efficient and accurate method for hip\u2010knee\u2010ankle angle measurement, with performance comparable to experienced orthopaedic surgeons. While promising, further development is necessary to address cases in which image quality or positioning issues prevent automated measurement and to reduce reliance on human quality control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70383","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:57:34Z","timestamp":1756281454000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Artificial intelligence\u2010guided assessment of the hip\u2010knee\u2010ankle angle shows excellent correlation with experienced human raters"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0957-2285","authenticated-orcid":false,"given":"Mikhail","family":"Salzmann","sequence":"first","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Prill","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Becker","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas G.","family":"Schreyer","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology Brandenburg Medical School Theodor Fontane Brandenburg an\u200ader Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Shabo","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology Brandenburg Medical School Theodor Fontane Brandenburg an\u200ader Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolai","family":"Ramadanov","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Brandenburg Medical School Theodor Fontane Brandenburg an der Havel 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