DEVELOPMENT OF TIBIOFEMORAL ANGEL IN CHILDREN OF SAUDI ARABIA

Objectives: Tibiofemoral angle (TFA), is anatomically formed by the intersection of the anatomical axis' of both the femur and tibia. The TFA differ according to age and ethnic groups. The aim of the current study is to determine clinically the mean value of the TFA, intercondylar distance (ICD) and intermalleolar distance (IMD) in children in Saudi Arabia for the age group 2 to 16 years and correlate the body mass index (BMI) to the lower limb alignment. Method: A total of 469 Saudi children (280 males and 189 females) were included in this study. The age range of participants was 2-16 years. We clinically measured using a goniometer for the TFA and a measuring tape for ICD and IMD. Result: The maximum mean TFA is found in the age group 13 years; in girls 9.70 degrees and in boys 11.75 degrees. There is a significant difference between the mean TFA of boys and girls in the age group of 13 years. The maximum valgus in girls was 16 degrees at age 5 and 6 years, and in boy was 18 degrees at age of 8 years. There is no varus alignment in the mean TFA in children older than 2 years. We found a statistically significant difference for the correlation coefficient of age with IMD. Both the ICD and IMD were variable with age. The BMI of the studied children has a negative correlation with the IMD [r = -0.086, P = 0.064]. There was no statistically significant correlation between the BMI and the mean TFA or the ICD. Conclusion: The development pattern was found to be different in Saudi children studied from the international patterns. The mean TFAs of different age groups is provided in this study. We believe our data could be considered as one of the references for evaluating lower limb alignment in Saudi children. Keywords: Bowlegs, intercondylar distance, intermalleolar distance, knee angle, tibiofemoral angle