{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T22:50:28Z","timestamp":1783810228345,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T00:00:00Z","timestamp":1686960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T00:00:00Z","timestamp":1686960000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T00:00:00Z","timestamp":1686960000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinik M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to quantify changes in rotation of the lower limb between image pairs based on patellar position. Additionally, we investigated the differences in alignment between centralized patellar and orthograde\u2010positioned condyles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three\u2010dimensional models of 30 paired legs were aligned in neutral position with condyles orthogonal to the sagittal axis and then rotated internally and externally in 1\u00b0 increments up to 15\u00b0. For each rotation, the deviation of the patella and the subsequent changes in alignment parameters were calculated and plotted using a linear regression model. Differences between neutral position and patellar centralization were analysed qualitatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A linear relationship between lower limb rotation and patellar position can be postulated. The regression model (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.99) calculated a change of the patellar position of \u2212 0.9\u00a0mm per degree rotation and alignment parameters showed small changes due to rotation. The physiological lateralization of the patella at neutral position was on average \u2212 8.3\u00a0mm (SD:\u2009\u00b1\u20095.4\u00a0mm). From neutral position, internal rotation that led to a centralized patella was on average \u2212 9.8\u00b0 (SD:\u2009\u00b1\u20095.2\u00b0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The approximately linear dependence of the patellar position on rotation allows an inverse estimation of the rotation during image acquisition and its influence on the alignment parameters. As there is still no absolute consensus about lower limb positioning during image acquisition, data about the impact of a centralized patella compared to an orthograde condyle positioning on alignment parameters was provided.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-023-07466-0","type":"journal-article","created":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T01:01:45Z","timestamp":1686963705000},"page":"4292-4298","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Linear correlation between patellar positioning and rotation of the lower limb in radiographic imaging: a 3D simulation study"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1877-7673","authenticated-orcid":false,"given":"Maximilian","family":"J\u00f6rgens","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics and Trauma Surgery Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Brunner","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics and Trauma Surgery Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Weigert","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Statistical Consulting Unit StaBLab LMU Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Bormann","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics and Trauma Surgery Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"B\u00f6hm","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics and Trauma Surgery Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfang","family":"B\u00f6cker","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics and Trauma Surgery Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander C.","family":"Paulus","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics and Trauma Surgery Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Ehrl","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Division of Hand, Plastic and Aesthetic Surgery University Hospital, LMU Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"F\u00fcrmetz","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics and Trauma Surgery Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich Germany"},{"name":"<!--<label>4<\/label>--> Department of Trauma Surgery BG Unfallklinikum Murnau Murnau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,17]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010021\u201004163\u2010w"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010022\u201007302\u2010x"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010018\u20100872\u20104"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2021.02.016"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2018.10.011"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2014.940573"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010017\u20100571\u20106"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005779\u20107"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100032\u20101313756"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010199610000\u201000014102\u2010106"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100039\u20101693668"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010014\u20103327\u20104"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2010.01.036"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010020\u201003487\u20109"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010198769050\u201000016"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2016.11.020"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/978\u20103\u2010642\u201059373\u20104"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0030\u20105898(20)31927\u20101"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109290(90)90378\u2010G"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100037\u20101603503"},{"key":"e_1_2_10_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/978\u20101\u20104612\u20102294\u20101_3"},{"key":"e_1_2_10_23_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100037\u20101604141"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-023-07466-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-023-07466-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-023-07466-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-023-07466-0","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T12:28:33Z","timestamp":1760876913000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-023-07466-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,17]]},"references-count":22,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1007\/s00167-023-07466-0"],"URL":"https:\/\/doi.org\/10.1007\/s00167-023-07466-0","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,17]]},"assertion":[{"value":"28 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 May 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Ethics Committee of the Ludwig-Maximilians-University -Munich (Nr. 17-044).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All authors have read and approved the manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}