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

Hyuck Min Kwon, Hee June Kim, Young Han Lee, Eshnazarov Eshnazarovich, Gil Han Lee, Jin Woo Lee, Ick Hwan Yang, Kwan Kyu Park

Research output: Contribution to journalArticle


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.

Original languageEnglish
Pages (from-to)252-257
Number of pages6
JournalJournal of Knee Surgery
Issue number3
Publication statusPublished - 2017 Mar 1


All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

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