title: Does Conventional Lateral Long Bone Radiography Present Sagittal Axes Accurately? A Comparison with Direct Lateral Long Bone Radiography.
abstract: To investigate the sagittal alignment, proper and consistent radiographic evaluation is needed. We sought to use an alternative method of obtaining the same view, a direct lateral view and compare it with the conventional method. Conventional lateral long bone radiography and direct lateral long bone radiography were undertaken by 74 consecutive patients undergoing total knee arthroplasty (TKA), preoperatively and postoperatively. Angles between sagittal axes and the mechanical axis (MA), and the visible hip joint area were measured. Postoperative angles between the MA and femoral implant were also significantly different between the two radiologic methods of conventional and direct lateral long bone radiography (92.1 ± 2.1 degrees vs. 94.4 ± 2.6 degrees,p= 0.034). Hip joint visibility was significantly inferior using the direct lateral method (p< 0.001). The angles on the sagittal axes on conventional radiography of the lower extremities were different from those on direct lateral long bone radiography. The direct lateral long bone radiographs show the true lateral view, and surgeons may consider using the direct lateral method when evaluating relevant alignments before and after TKAs. For obese patients, however, conventional or combined methods should be considered because of inferior visibility of the hip joint using the direct method.
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyuck Min
authors.initials: HM
authors.lastname: Kwon
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hee June
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Han
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Traumatology, Neurosurgery, and Military Field Surgery, Samarkand State Medical Institute, Uzbekistan, Uzbekistan.
authors.forename: Eshnazarov
authors.initials: E
authors.lastname: Eshnazarovich
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Gil Han
authors.initials: GH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ick Hwan
authors.initials: IH
authors.lastname: Yang
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kwan Kyu
authors.initials: KK
authors.lastname: Park
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D015992:Body Mass Index; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging*; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011859:Radiography; D016059:Range of Motion, Articular; D013977:Tibia / Q000000981:diagnostic imaging*