{"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":1792852525027,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T00:00:00Z","timestamp":1690243200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T00:00:00Z","timestamp":1690243200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T00:00:00Z","timestamp":1690243200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to understand if differences exist between computed tomography (CT) and long leg radiographs (LLR) when defining coronal plane alignment of the lower limb in total knee arthroplasty (TKA). It aimed to identify any such differences between the two imaging modalities by quantifying constitutional limb alignment (arithmetic hip\u2013knee\u2013ankle angle (aHKA), joint line obliquity (JLO) and Coronal Plane Alignment of the Knee (CPAK) type within the same population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective radiographic study compared pre\u2010operative LLR and CT measurements in patients undergoing robotic\u2010assisted TKA. The aHKA, JLO and CPAK types were calculated after measuring the medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA). The primary outcomes were the mean differences in aHKA (MPTA\u2212LDFA), JLO (MPTA\u2009+\u2009LDFA) and proportions of CPAK types between LLR and CT groups. The secondary outcomes were the differences in CT\u2010derived MPTA values based on four different tibial sagittal landmarks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After exclusions, 465 imaging sets were analysed in 394 patients. There was a statistically significant mean difference between LLR and CT, respectively, for both MPTA (87.5\u00b0 vs. 86.2\u00b0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and LDFA (88.7\u00b0 vs. 87.3\u00b0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). There were also statistically significant differences for aHKA (\u2212 0.2\u00b0 vs. \u2212 1.1\u00b0) and JLO (175.1\u00b0 vs. 173.4\u00b0) for LLR and CT, respectively (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). CT increased the proportion of patients with CPAK Type I (constitutional varus aHKA, apex distal JLO) and CPAK Type II (neutral aHKA, apex distal JLO), and decreased numbers of CPAK Types III\u2013VI. There were significant mean differences in the MPTA using varying sagittal landmarks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Alignment determined by LLRs underestimates the magnitude of both constitutional varus alignment and joint line obliquity compared to CT, differences that notably increase the proportions of patients included in CPAK Types I and II. These distinctions are primarily due to underestimation of proximal tibial varus when measured on LLRs compared to CT, which more specifically defines articular weight\u2010bearing points.<\/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\/s00167-023-07505-w","type":"journal-article","created":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T07:01:52Z","timestamp":1690268512000},"page":"4755-4765","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Long leg radiographs underestimate the degree of constitutional varus limb alignment and joint line obliquity in comparison with computed tomography: a radiographic study"],"prefix":"10.1002","volume":"31","author":[{"given":"Payam","family":"Tarassoli","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Sydney Knee Specialists Suite 201, Level 2, 131 Princes Hwy 2217 Kogarah NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke E.","family":"Corban","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/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>1<\/label>--> Sydney Knee Specialists Suite 201, Level 2, 131 Princes Hwy 2217 Kogarah NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Sergis","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Stryker Australia 8 Herbert St 2065 St Leonards NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren B.","family":"Chen","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Sydney Knee Specialists Suite 201, Level 2, 131 Princes Hwy 2217 Kogarah NSW Australia"},{"name":"<!--<label>2<\/label>--> St George Private Hospital 1 South St 2217 Kogarah NSW Australia"}],"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>--> Sydney Knee Specialists Suite 201, Level 2, 131 Princes Hwy 2217 Kogarah NSW Australia"},{"name":"<!--<label>2<\/label>--> St George Private Hospital 1 South St 2217 Kogarah NSW Australia"},{"name":"<!--<label>4<\/label>--><!--<institution-id institution-id-type=\"ROR\">https:\/\/ror.org\/03r8z3t63<\/institution-id>--> School of Clinical Medicine University of New South Wales, St George and Sutherland Campuses Sydney NSW 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need for a standardized whole leg radiograph guideline: the effects of knee flexion, leg rotation, and X\u2010ray beam height","volume":"1","author":"Nguyen HC","year":"2021","journal-title":"J Cart Jt Preserv"},{"key":"e_1_2_12_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010022\u201006890\u2010y"},{"key":"e_1_2_12_29_2","volume-title":"Principles of deformity correction","author":"Paley 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Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-023-07505-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-023-07505-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-023-07505-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-023-07505-w","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T09:51:27Z","timestamp":1760867487000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-023-07505-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,25]]},"references-count":37,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1007\/s00167-023-07505-w"],"URL":"https:\/\/doi.org\/10.1007\/s00167-023-07505-w","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,25]]},"assertion":[{"value":"9 May 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 July 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 July 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No conflicts to declare: Payam Tarassoli, Jil Wood, Luke Corban. Andrew Sergis: Paid employee of company (Stryker). Darren Chen and Samuel MacDessi: Speakers\u2019 bureau\/paid presentations for a company or supplier (Stryker, Smith and Nephew); Paid consultant for a company or supplier (Stryker, Amplitude SAS); Research support from a company or supplier as a principal investigator for an unrelated study (Ramsay Hospital Research Foundation); Other financial support or material from a company or supplier (Research fellowship funding from Smith and Nephew, Stryker and Zimmer Biomet; IP pertaining to an unrelated study acquired by Stryker, with patent application lodged on key components of that\u00a0IP).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethics approval was granted by Ramsay Health Care to perform the analysis (approval number: 2022\/ETH\/0131). All investigations and procedures undertaken were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained in accordance with the ethical standards of the institutional research committee and obtained from all participants in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}