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J Knee Surg 2017; 30(03): 252-257
DOI: 10.1055/s-0036-1584537
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Does Conventional Lateral Long Bone Radiography Present Sagittal Axes Accurately? A Comparison with Direct Lateral Long Bone Radiography

Hyuck Min Kwon
1   Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Hee June Kim
1   Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Young Han Lee
2   Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Eshnazarov Eshnazarovich
3   Department of Traumatology, Neurosurgery, and Military Field Surgery, Samarkand State Medical Institute, Uzbekistan, Uzbekistan
,
Gil Han Lee
1   Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Jin Woo Lee
1   Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Ick Hwan Yang
1   Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Kwan Kyu Park
1   Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
› Author Affiliations
Further Information

Publication History

25 November 2015

09 May 2016

Publication Date:
30 June 2016 (online)

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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.

Keywords

total knee arthroplasty - lateral long bone radiography - direct method - sagittal axes - implant position
 

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