{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T23:21:15Z","timestamp":1787440875904,"version":"build-2736575974"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,22]]},"DOI":"10.7759\/cureus.114993","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T22:30:51Z","timestamp":1787437851000},"source":"Crossref","is-referenced-by-count":0,"title":["Standing Long-Leg Radiographs Underestimate Varus Alignment and Joint Line Obliquity Compared With Computed Tomography in Japanese Patients"],"prefix":"10.7759","author":[{"given":"Yoshika","family":"Hiratsuka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Maeyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Ishimatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotaro","family":"Miyazaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Hideshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuaki","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-023-07505-w","article-title":"Long leg radiographs underestimate the degree of constitutional varus limb alignment and joint line obliquity in comparison with computed tomography: a radiographic study","volume":"31","author":"Tarassoli P","year":"2023","unstructured":"Tarassoli P, Corban LE, Wood JA, Sergis A, Chen DB, MacDessi SJ. Long leg radiographs underestimate the degree of constitutional varus limb alignment and joint line obliquity in comparison with computed tomography: a radiographic study. Knee Surg Sports Traumatol Arthrosc. 2023, 31:4755-65. 10.1007\/s00167-023-07505-w","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-022-04354-9","article-title":"Influence of axial limb rotation on radiographic lower limb alignment: a systematic review","volume":"142","author":"Ahrend MD","year":"2022","unstructured":"Ahrend MD, Baumgartner H, Ihle C, Histing T, Schroter S, Finger F. Influence of axial limb rotation on radiographic lower limb alignment: a systematic review. Arch Orthop Trauma Surg. 2022, 142:3349-66. 10.1007\/s00402-022-04354-9","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjp.2021.100022","article-title":"The need for a standardized whole leg radiograph guideline: the effects of knee flexion, leg rotation, and X-ray beam height","volume":"1","author":"Nguyen HC","year":"2021","unstructured":"Nguyen HC, Gielis WP, van Egmond N, et al.. The need for a standardized whole leg radiograph guideline: the effects of knee flexion, leg rotation, and X-ray beam height. J Cartil Joint Preserv. 2021, 1:100022. 10.1016\/j.jcjp.2021.100022","journal-title":"J Cartil Joint Preserv"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06283-z","article-title":"MAKO CT-based robotic arm-assisted system is a reliable procedure for total knee arthroplasty: a systematic review","volume":"29","author":"Batailler C","year":"2021","unstructured":"Batailler C, Fernandez A, Swan J, Servien E, Haddad FS, Catani F, Lustig S. MAKO CT-based robotic arm-assisted system is a reliable procedure for total knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2021, 29:3585-98. 10.1007\/s00167-020-06283-z","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2023.07.011","article-title":"Does preoperative 3D CT planning helps in predicting the component size determination and alignment in automatic robotic total knee arthroplasty (RA-TKA)","volume":"43","author":"Bhor P","year":"2023","unstructured":"Bhor P, Pawar S, Kutumbe D, Vatkar A, Kale S, Jagtap R. Does preoperative 3D CT planning helps in predicting the component size determination and alignment in automatic robotic total knee arthroplasty (RA-TKA). J Orthop. 2023, 43:25-9. 10.1016\/j.jor.2023.07.011","journal-title":"J Orthop"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1742645","article-title":"Distribution of coronal plane alignment of the knee classification in patients with knee osteoarthritis in Japan","volume":"36","author":"Toyooka S","year":"2023","unstructured":"Toyooka S, Osaki Y, Masuda H, et al.. Distribution of coronal plane alignment of the knee classification in patients with knee osteoarthritis in Japan. J Knee Surg. 2023, 36:738-43. 10.1055\/s-0042-1742645","journal-title":"J Knee Surg"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2024.12.010","article-title":"The coronal plane alignment of the knee classification of a Japanese population indicates more varus deformity tendency compared with European countries","volume":"53","author":"Kubota M","year":"2025","unstructured":"Kubota M, Kaneko H, Yoshida K, et al.. The coronal plane alignment of the knee classification of a Japanese population indicates more varus deformity tendency compared with European countries. Knee. 2025, 53:246-54. 10.1016\/j.knee.2024.12.010","journal-title":"Knee"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.103B2.BJJ-2020-1050.R1","article-title":"Coronal Plane Alignment of the Knee (CPAK) classification: a new system for describing knee phenotypes","volume":"103-B","author":"MacDessi SJ","year":"2021","unstructured":"MacDessi SJ, Griffiths-Jones W, Harris IA, Bellemans J, Chen DB. Coronal Plane Alignment of the Knee (CPAK) classification: a new system for describing knee phenotypes. Bone Joint J. 2021, 103-B:329-37. 10.1302\/0301-620X.103B2.BJJ-2020-1050.R1","journal-title":"Bone Joint J"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12156","article-title":"Constitutional varus knee due to tibial deformity is common and represents a good indication for high tibial osteotomy in Japanese population: consideration of 1010 knees","volume":"32","author":"Abe K","year":"2024","unstructured":"Abe K, Goshima K, Morinaga T, et al.. Constitutional varus knee due to tibial deformity is common and represents a good indication for high tibial osteotomy in Japanese population: consideration of 1010 knees. Knee Surg Sports Traumatol Arthrosc. 2024, 32:1332-43. 10.1002\/ksa.12156","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.64822","article-title":"A morphological study of distal femoral varus deformity","volume":"16","author":"Hara J","year":"2024","unstructured":"Hara J, Maeyama A, Ishimatsu T, Matsunaga T, Nakayama S, Yamamoto T. A morphological study of distal femoral varus deformity. Cureus. 2024, 16:e64822. 10.7759\/cureus.64822","journal-title":"Cureus"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-1936-5","article-title":"The Chitranjan Ranawat award: is neutral mechanical alignment normal for all patients? The concept of constitutional varus","volume":"470","author":"Bellemans J","year":"2012","unstructured":"Bellemans J, Colyn W, Vandenneucker H, Victor J. The Chitranjan Ranawat award: is neutral mechanical alignment normal for all patients? The concept of constitutional varus. Clin Orthop Relat Res. 2012, 470:45-53. 10.1007\/s11999-011-1936-5","journal-title":"Clin Orthop Relat Res"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05508-0","article-title":"Phenotyping the knee in young non-osteoarthritic knees shows a wide distribution of femoral and tibial coronal alignment","volume":"27","author":"Hirschmann MT","year":"2019","unstructured":"Hirschmann MT, Moser LB, Amsler F, Behrend H, Leclercq V, Hess S. Phenotyping the knee in young non-osteoarthritic knees shows a wide distribution of femoral and tibial coronal alignment. Knee Surg Sports Traumatol Arthrosc. 2019, 27:1385-93. 10.1007\/s00167-019-05508-0","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.33.BJO-2022-0001.R1","article-title":"Validation and modification of the Coronal Plane Alignment of the Knee classification in the Asian population","volume":"3","author":"Hsu CE","year":"2022","unstructured":"Hsu CE, Chen CP, Wang SP, Huang JT, Tong KM, Huang KC. Validation and modification of the Coronal Plane Alignment of the Knee classification in the Asian population. Bone Jt Open. 2022, 3:211-7. 10.1302\/2633-1462.33.BJO-2022-0001.R1","journal-title":"Bone Jt Open"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-06890-y","article-title":"Medial proximal tibial angle at the posterior tibial plateau represents the pre-arthritic constitutional medial proximal tibial angle in anterior cruciate ligament-intact, advanced osteoarthritis of the knee","volume":"30","author":"Ogawa H","year":"2022","unstructured":"Ogawa H, Nakamura Y, Sengoku M, et al.. Medial proximal tibial angle at the posterior tibial plateau represents the pre-arthritic constitutional medial proximal tibial angle in anterior cruciate ligament-intact, advanced osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc. 2022, 30:2941-7. 10.1007\/s00167-022-06890-y","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4636-1","article-title":"Measurement of lower limb alignment: there are within-person differences between weight-bearing and non-weight-bearing measurement modalities","volume":"25","author":"Schoenmakers DA","year":"2017","unstructured":"Schoenmakers DA, Feczko PZ, Boonen B, Schotanus MG, Kort NP, Emans PJ. Measurement of lower limb alignment: there are within-person differences between weight-bearing and non-weight-bearing measurement modalities. Knee Surg Sports Traumatol Arthrosc. 2017, 25:3569-75. 10.1007\/s00167-017-4636-1","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2013.11.003","article-title":"Dynamic contact mechanics on the tibial plateau of the human knee during activities of daily living","volume":"47","author":"Gilbert S","year":"2014","unstructured":"Gilbert S, Chen T, Hutchinson ID, Choi D, Voigt C, Warren RF, Maher SA. Dynamic contact mechanics on the tibial plateau of the human knee during activities of daily living. J Biomech. 2014, 47:2006-12. 10.1016\/j.jbiomech.2013.11.003","journal-title":"J Biomech"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.25.BJO-2021-0028.R1","article-title":"Arithmetic hip-knee-ankle angle (aHKA): An algorithm for estimating constitutional lower limb alignment in the arthritic patient population","volume":"2","author":"Griffiths-Jones W","year":"2021","unstructured":"Griffiths-Jones W, Chen DB, Harris IA, Bellemans J, MacDessi SJ. Arithmetic hip-knee-ankle angle (aHKA): An algorithm for estimating constitutional lower limb alignment in the arthritic patient population. Bone Jt Open. 2021, 2:351-8. 10.1302\/2633-1462.25.BJO-2021-0028.R1","journal-title":"Bone Jt Open"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-91","article-title":"The McNemar test for binary matched-pairs data: mid-p and asymptotic are better than exact conditional","volume":"13","author":"Fagerland MW","year":"2013","unstructured":"Fagerland MW, Lydersen S, Laake P. The McNemar test for binary matched-pairs data: mid-p and asymptotic are better than exact conditional. BMC Med Res Methodol. 2013, 13:91. 10.1186\/1471-2288-13-91","journal-title":"BMC Med Res Methodol"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2621-x","article-title":"Accurate alignment and high function after kinematically aligned TKA performed with generic instruments","volume":"21","author":"Howell SM","year":"2013","unstructured":"Howell SM, Papadopoulos S, Kuznik KT, Hull ML. Accurate alignment and high function after kinematically aligned TKA performed with generic instruments. Knee Surg Sports Traumatol Arthrosc. 2013, 21:2271-80. 10.1007\/s00167-013-2621-x","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2015.08.006","article-title":"Does malrotation of the tibial and femoral components compromise function in kinematically aligned total knee arthroplasty?","volume":"47","author":"Nedopil AJ","year":"2016","unstructured":"Nedopil AJ, Howell SM, Hull ML. Does malrotation of the tibial and femoral components compromise function in kinematically aligned total knee arthroplasty?. Orthop Clin North Am. 2016, 47:41-50. 10.1016\/j.ocl.2015.08.006","journal-title":"Orthop Clin North Am"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/497196-standing-long-leg-radiographs-underestimate-varus-alignment-and-joint-line-obliquity-compared-with-computed-tomography-in-japanese-patients","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T22:30:51Z","timestamp":1787437851000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/497196-standing-long-leg-radiographs-underestimate-varus-alignment-and-joint-line-obliquity-compared-with-computed-tomography-in-japanese-patients"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,22]]},"references-count":20,"URL":"https:\/\/doi.org\/10.7759\/cureus.114993","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8,22]]}}}