Table 6 Results of studies examining the relationship between transverse plane femoral alignment and biomechanics during a functional task
Study (year) | Clinical Measure(s) | Clinical Measure(s) Mean (SD) (high risk, low risk (if applicable) | Reliability of Clinical Measure (ICC(SEM) | Functional Task | Outcome Measure(s) | P value | Effect size (Cohen’s d) |
|---|---|---|---|---|---|---|---|
Bell et al. (2008) [4] | External rotation ROM | 61.3(9.0), 51.9(10.9) | .87-.96 (1.6–2.6°) | Overhead squat | 2D medial knee displacement | .01 | 0.9 |
Bittencourt et al. (2012) [6] | Internal rotation ROM | 41.6(13.1), 46.3(15.1) 46.9(11.6), 44.6(17.0) | .99 (1.5°) | Single leg squat and jump landing | Frontal plane projection angle | .04 .43 | 0.3 0.2 |
Breen et al. (2010) [9] | Internal rotation ROM External rotation ROM | 30.29(8.8), 44.46(6.0) 43.21(8.7), 46.54(8.0) | Not reported | Maximal drop jump with diagonal side cut | Knee flexion at initial contact Hip flexion at initial contact Dorsiflexion at initial contact Thigh rotation at initial contact Shank rotation at initial contact | .003 .87 .31 .32 .14 | 1.8 0.1 0.6 0.5 0.8 |
Hogg et al (2019) [20] | Internal rotation ROM External rotation ROM Femoral anteversion | 31.3 ± 8.4 44.6 ± 9.8 10.3 ± 5.8 | .97(1.6) .85(3.3) .92(1.2) | Single-leg forward landing | Peak hip adduction moment | .63 .75 .91 | 0.8 0.2 0.1 |
Peak hip internal rotation moment | .10 .85 .07 | 0.8 0.1 0.9 | |||||
Peak knee abduction moment | .05 .95 .57 | 1.0 0.0 0.3 | |||||
Peak knee internal rotation moment | .16 .09 .92 | 0.7 0.9 0.0 | |||||
Peak hip adduction angle | .47 .78 .88 | 0.3 0.1 0.1 | |||||
Peak hip internal rotation angle | .40 .70 .13 | 0.4 0.2 0.7 | |||||
Peak knee abduction angle | .63 .81 .87 | 0.2 0.1 0.1 | |||||
Peak knee internal rotation angle | .68 .36 .86 | 0.2 0.4 0.1 | |||||
Hogg et al. (2021) [19] | Internal rotation ROM External rotation ROM Femoral anteversion | .97(1.6) .85(3.3) .92(1.2) | Single-leg forward landing | Peak hip adduction moment | .07 .77 .02 | 0.4 0.1 0.5 | |
Peak hip internal rotation moment | .01 .10 .32 | 0.6 0.4 0.2 | |||||
Peak knee abduction moment | .12 .95 .80 | 0.3 0.0 0.1 | |||||
Peak knee internal rotation moment | .66 .29 .86 | 0.1 0.2 0.0 | |||||
Peak hip adduction angle | .11 .69 .08 | 0.3 0.1 0.4 | |||||
Peak hip internal rotation angle | .002 .01 .01 | 0.7 0.6 0.6 | |||||
Peak knee abduction angle | .001 .89 .05 | 0.7 0.0 0.4 | |||||
Peak knee internal rotation angle | .43 .05 .32 | 0.2 0.4 0.2 | |||||
Howard et al. (2011) [21] | Internal rotation ROM External rotation ROM | 29.0(11.0) 35.0(7.0) | .99(.5°) .95(1.9°) | Single-leg jump landing | Hip adduction excursion | .02 | 0.8 |
Knee abduction excursion | .001 | 1.2 | |||||
Knee adduction excursion | .03 | 0.7 | |||||
Knee external rotation excursion | .005 | 0.9 | |||||
Kaneko et al. (2013) [26] | Femoral anteversion | 20.7(3.3), 16.1(1.7) | Not reported | Single-leg jump landing | Hip flexion at IC and 100 ms PC | .01, .01 | 1.6, 1.7 |
Hip abduction at IC and peak | .38, .10 | 0.5, 1.1 | |||||
Knee flexion at IC and peak | .42, .04 | 0.5, 1.4 | |||||
Knee valgus at IC and peak | 1.00, .03 | 0.0, 1.5 | |||||
Mauntel et al. (2013) [35] | Internal rotation ROM External rotation ROM Femoral anteversion | 59.6(8.1), 54.7(9.9) 72.4(7.3), 69.9(12.0) 3.2(2.8), 3.5(3.1) | .89(4.5°) .64(7.5°) .73(0.9°) | Single-leg squat | Visual medial knee displacement | .09 .43 .75 | 0.5 0.3 0.1 |
Nguyen et al (2015) [40] | Femoral anteversion | 15.3(5.2), 9.7(4.7) | > .87 (SEM not reported) | Double-leg drop jump | Hip flexion angle | .07 | 0.2 |
Hip adduction angle | .34 | 0.2 | |||||
Hip IR angle | .16 | 0.2 | |||||
Knee flexion angle | .37 | 0.4 | |||||
Knee valgus angle | .02 | 0.4 | |||||
Knee ER angle | .45 | 0.1 | |||||
Hip flexion moment | .36 | 0.2 | |||||
Hip adduction moment | .11 | 0.3 | |||||
Hip IR moment | .07 | 0.3 | |||||
Knee flexion moment | .46 | 0.1 | |||||
Knee valgus moment | .02 | 0.4 | |||||
Knee ER moment | .002 | 0.6 | |||||
Nguyen et al. (2011) [38] | Femoral anteversion | 10.7(5.2) | > .87(SEM not reported) | Single-leg squat | Hip internal rotation excursion | .06 | 0.5 |
Knee valgus excursion | .82 | 0.1 | |||||
Knee external rotation excursion | .006 | 0.8 | |||||
Rabin & Kozol (2010) [44] | Internal rotation ROM External rotation ROM | 41.1(7.9), 48.4(7.4) 62.2(7.4),63.0(4.2) | .91(SEM not reported) .82(SEM not reported) | Lateral step-down | 5-point 2D visual criteria (“arm strategy, trunk alignment, pelvis plane, knee position, steady stance”) | .03 .77 | 1.0 0.1 |
Stiffler et al. (2015) [47] | Internal rotation ROM External rotation ROM Femoral anteversion | 31.9(11.2), 34.2(11.0) 46.1(14.3), 43.3(12.6) 9.7(6.8), 9.4(5.4) | Not reported | Double-leg jump landing | 2D medial knee displacement | .61 .25 .81 | 0.1 0.2 0.2 |