{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T14:35:25Z","timestamp":1792852525793,"version":"4.5.0"},"reference-count":54,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T00:00:00Z","timestamp":1657497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T00:00:00Z","timestamp":1657497600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T00:00:00Z","timestamp":1657497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100012481","name":"University of New South Wales Canberra","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012481","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Kinematically aligned total knee arthroplasty (KA TKA) relies on precise determination of constitutional alignment to set resection targets. The arithmetic hip\u2010knee\u2010ankle angle (aHKA) is a radiographic method to estimate constitutional alignment following onset of arthritis. Intraoperatively, constitutional alignment may also be approximated using navigation\u2010based angular measurements of deformity correction, termed the stressed HKA (sHKA). This study aimed to investigate the relationship between these methods of estimating constitutional alignment to better understand their utility in KA TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A radiological and intraoperative computer\u2010assisted navigation study was undertaken comparing measurements of the aHKA using radiographs and computed tomography (CT\u2010aHKA) to the sHKA in 88 TKAs meeting the inclusion criteria. The primary outcome was the difference in the paired means between the three methods to determine constitutional alignment (aHKA, CT\u2010aHKA, sHKA). Secondary outcomes included testing agreement across measurements using Bland\u2010Altman plots and analysis of subgroup differences based on different patterns of compartmental arthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were no statistically significant differences between any paired comparison or across groups (aHKA vs. sHKA: 0.1\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.817; aHKA vs. CT\u2010aHKA: 0.3\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.643; CT\u2010aHKA vs. sHKA: 0.2\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.722; ANOVA,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.845). Bland\u2010Altman plots were consistent with good agreement for all comparisons, with approximately 95% of values within limits of agreement. There was no difference in the three paired comparisons (aHKA, CT\u2010aHKA, and sHKA) for knees with medial compartment arthritis. However, these findings were not replicated in knees with lateral compartment arthritis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There was no significant difference between the arithmetic HKA (whether obtained using CT or radiographs) and the stressed HKA in this analysis. These findings further validate the preoperative arithmetic method and support use of the intraoperative stressed HKA as techniques to restore constitutional lower limb alignment in KA TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00167-022-07038-8","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T07:03:06Z","timestamp":1657609386000},"page":"2980-2990","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Arithmetic hip\u2010knee\u2010ankle angle and stressed hip\u2010knee\u2010ankle angle: equivalent methods for estimating constitutional lower limb alignment in kinematically aligned total knee arthroplasty"],"prefix":"10.1002","volume":"30","author":[{"given":"Payam","family":"Tarassoli","sequence":"first","affiliation":[{"name":"<!--<label>2<\/label>--> Sydney Knee Specialists Suite 201, Level 2, 131 Princes Hwy 2217 Kogarah NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jil A.","family":"Wood","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Sydney Knee Specialists Suite 201, Level 2, 131 Princes Hwy 2217 Kogarah NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren B.","family":"Chen","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> CPAK Research Group Sydney Australia"},{"name":"<!--<label>2<\/label>--> Sydney Knee Specialists Suite 201, Level 2, 131 Princes Hwy 2217 Kogarah NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Will","family":"Griffiths\u2010Jones","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> CPAK Research Group Sydney Australia"},{"name":"<!--<label>3<\/label>--> North Devon District Hospital Raleigh Heights Barnstaple UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Bellemans","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> CPAK Research Group Sydney Australia"},{"name":"<!--<label>4<\/label>--> ZOL Hospitals Genk Belgium"},{"name":"<!--<label>5<\/label>--> ArthroClinic Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1578-7614","authenticated-orcid":false,"given":"Samuel J.","family":"MacDessi","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> CPAK Research Group Sydney Australia"},{"name":"<!--<label>2<\/label>--> Sydney Knee Specialists Suite 201, Level 2, 131 Princes Hwy 2217 Kogarah NSW Australia"},{"name":"<!--<label>6<\/label>--> St George and Sutherland Clinical School University of New South Wales Sydney NSW 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Paid consultant for a company or supplier\u2014Stryker, Amplitude SAS. Research support from a company or supplier as a Principal Investigator for an unrelated study\u2014Ramsay Hospital Research Foundation. Other financial or material support from a company or supplier\u2014Research fellowship funding from Smith & Nephew, Stryker and Zimmer Biomet; IP pertaining to an unrelated study acquired by Stryker; patent application lodged on key components of the unrelated IP. Payam Tarassoli, Jil Wood, Johann Bellemans: None to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Approval was granted from our local research governance unit.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}