Index to Chiropractic Literature
Index to Chiropractic Literature
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Monday, October 27, 2025
Index to Chiropractic LiteratureIndex to Chiropractic LiteratureIndex to Chiropractic Literature
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Article ID
Title
URL https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947998/
Journal J Chiropr Med. 2023 Mar;22(1):72-84
Author(s)
Subject(s)
Peer Review Yes
Publication Type Article
Abstract/Notes

Objective: The purpose of this literature review was to identify knee alignment assessment methods using radiography in the sagittal and frontal planes and to identify normality values for classifying knee alignment using these methods.

Methods: A systematic review with a meta-analysis was conducted. The eligibility criterion was studies that performed radiographic examinations to assess the knee alignment of adults without a history of hip or knee prosthesis surgery. The methodological qualities of the included studies were assessed using the QUADAS-2 tool. A meta-analysis was performed to measure the normality values of knee alignment in the frontal plane.

Results: The hip-knee-ankle (HKA) angle was the measure most frequently used to assess knee alignment. Only a meta-analysis of HKA normality values was possible. Thereby, we found normality values of the HKA angle for the overall population, men, and women. The normality values of knee alignment for healthy adults that were found in this study were as follows: overall sample (male and female patients) HKA angle = –0.2° (–2.8° to 2.41°), male patient HKA angle = 0.77° (–2.91° to 7.94°), and female patient HKA angle = –0.67° (–5.32° to 3.98°).

Conclusion: This review identified the most common methods and expected values for knee alignment assessment methods using radiography in the sagittal and frontal planes. We suggest HKA angles ranging from –3° to 3° as the cutoff for classifying knee alignment in the frontal plane, in accordance with the normality limits found in the meta-analysis.

Author Keywords:  Knee; Radiography; Meta-Analysis

This abstract is reproduced with the permission of the publisher; click on the above link for free full text. PubMed Record | PDF


 

      

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