{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T20:54:37Z","timestamp":1789937677397,"version":"4.0.1"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate a software\u2010based measurement tool of computed tomography imaging to assess torsional alignment of the lower limb\u2014usually used for patients with posttraumatic deformities and patellofemoral issues\u2014and compare these measurements with manual measurements of two experienced raters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a retrospective analysis of 58 lower limbs (47 patients, 20 men and 27 women) aged between 19 and 97 years. Inclusion criteria were the clinical indication for torsion measurement of the lower limb. Legs with incomplete imaging and age less than 18 years were excluded. Femoral and tibial torsion were measured separately. Torsional alignment was assessed software\u2010based at two time points by two raters. Rater one additionally assessed manual\u2010based measurement at two time points. The software used was mediCAD 3D Knee Version 2.5.33 (Hectec). Subsequently, intra\u2010 and inter\u2010rater reliability was calculated using the intraclass correlation coefficient (ICC). Validity testing was performed by means of precision, concordance correlation coefficient according to Lin (ccc) and Pearson correlation coefficient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>High intra\u2010rater reliability for software\u2010based as well as manual\u2010based evaluation of torsional alignment was found for the tibia as well as the femur (ICC ranging between 0.870 and 0.993). Inter\u2010rater reliability also showed highly significant results of both manual and software\u2010based measurements (ICC ranging between 0.851 and 0.993). For almost all comparisons (except the tibia left), software\u2010based measurements showed higher ICC scores above 0.9, and, therefore, classified as \u2018excellent reliability\u2019. For validity testing, correlation coefficients and precision showed very good correspondence of the measurements (all values\u2009&gt;\u20090.9), without systematic deviations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Software\u2010based measurement of torsional alignment according to the measurement method developed by H.\u2010A. Waidelich proved to be a reliable and valid technique. Especially for inexperienced surgeons, software\u2010based measurement, therefore, might improve confidence in reliable medical decisions in diagnostics and treatment.<\/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\/ksa.12509","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T06:46:20Z","timestamp":1729493180000},"page":"2095-2103","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Validation of a software\u2010based torsional measurement method of the lower limb: A retrospective study"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3516-8906","authenticated-orcid":false,"given":"Leonard","family":"Gr\u00fcnwald","sequence":"first","affiliation":[{"name":"Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"},{"name":"Osteotomie Komitee der Deutschen Kniegesellschaft M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1559-9127","authenticated-orcid":false,"given":"Shuntaro","family":"Nejima","sequence":"additional","affiliation":[{"name":"Yokohama City University School of Medicine Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Histing","sequence":"additional","affiliation":[{"name":"Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Schr\u00f6ter","sequence":"additional","affiliation":[{"name":"Diakonie Klinikum GmbH Jung\u2010Stilling Krankenhaus Siegen Siegen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hagedorn","sequence":"additional","affiliation":[{"name":"Klinikverbund S\u00fcdwest, Kliniken Sindelfingen Sindelfingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-018-0550-6"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-011-1303-8"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12112679"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07190-1"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00132-019-03752-3"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.137.1.97"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200408000-00002"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-016-2536-3"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-013-1289-8"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07528-8"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11071209"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.2307\/2532051"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-011-1185-4"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1515\/ijb-2015-0039"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198769080-00010"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20121023-30"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2114-3"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.18.01115"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-009-1236-5"},{"key":"e_1_2_12_21_1","first-page":"609","article-title":"[Computerized 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