A novel method for determining the Femoral-Tibial Angle of Knee Osteoarthritis on X-ray radiographs: data from the Osteoarthritis Initiative

Rima Tri Wahyuningrum, I. Ketut Eddy Purnama, Gijsbertus Jacob Verkerke, Peter M.A. van Ooijen, Mauridhi Hery Purnomo*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
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Femoral-tibial alignment is a prominent risk factor for Knee Osteoarthritis (KOA) incidence and progression. One way of assessing alignment is by determining the Femoral-Tibial Angle (FTA). Several studies have investigated FTA determination; however, methods of assessment of FTA still present challenges. This paper introduces a new method for semi-automatic measurement of FTA as part of KOA research. Our novel approach combines preprocessing of X-ray images and the use of Active Shape Model (ASM) as the femoral and tibial segmentation method, followed by a thinning process. The result of the thinning process is used to predict FTA automatically by measuring the angle between the intersection of the two vectors of branching points on the femoral and tibial areas. The proposed method is trained on 10 x-ray images and tested on 50 different x-ray images of the Osteoarthritis Initiative (OAI) dataset. The outcomes of this approach were compared with manually obtained FTA measurements from the OAI dataset as the ground truth. Based on experiments, the difference in measurement results between the FTA of the OAI and the FTA obtained using our method is quite small, i.e., below 0.81 for the right FTA and below 0.77 for the left FTA with minimal average errors. This result indicates that this method is clinically suitable for semi-automatic measurement of the FTA.

Computer science; Medical imaging; Knee osteoarthritis; X-ray; Femoral-tibial angle; Active shape model

Original languageEnglish
Article numbere04433
Number of pages11
Issue number8
Publication statusPublished - Aug 2020


  • UT-Gold-D
  • Active shape model
  • Computer science
  • Femoral-tibial angle
  • Knee osteoarthritis
  • Medical imaging
  • X-ray

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