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. 2022 May 18;13(5):427–443. doi: 10.5312/wjo.v13.i5.427

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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

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The malalignment test. The mechanical axis (MA) is traced from the center of the femoral head to the center of the ankle. The metaphyseal-diaphyseal angle (MAD) is calculated in millimeters (dotted lines in the image traced from center of knee and MA). If the MAD exceeds the threshold of normality, it is necessary to find the source of the deformity. The mechanical lateral distal femur angle. Medial proximal tibial angle are evaluated. A: Varus; B: Normal; C: Valgus. MAD: Metaphyseal-diaphyseal angle; MPTA: Medial proximal tibial angle; mLDFA: Mechanical lateral distal femur angle.