{
  "abstract": "Introduction\n\nCoronal alignment following total knee arthroplasty (TKA) is commonly assessed using radiographs, but postoperative radiographic protocols are not standardised. This study evaluated agreement between coronal alignment measured on short-leg and standing long-leg radiographs. We hypothesised that, in knees demonstrating varus alignment on standing long-leg radiographs, short-leg radiographs would demonstrate greater apparent varus.Methods\n\nThis retrospective cross-sectional study included 62 sequentially selected patients following primary TKA. All included patients had both postoperative short-leg and standing long-leg radiographic examinations available for analysis. Coronal alignment was assessed using the β angle. Agreement was evaluated using paired differences and Bland-Altman analysis. Interobserver reliability was assessed across six observers (two primary observers and four additional colleagues) using ICC(2,6). Intraobserver reliability was assessed using ICC(3,1).Results\n\nThe mean paired difference (short-leg minus standing long-leg) was -1.13° (95% confidence interval [CI]: -1.40° to -0.85°), indicating a systematic shift towards a more varus measurement on short-leg radiographs. The 95% limits of agreement were -4.08° to -1.82°, and 29% of measurements differed by more than 2°. In the 47 varus knees, the mean difference was -0.79° (95% CI: -1.18° to -0.40°; p < 0.001). In the valgus subgroup (n = 14; one neutral knee excluded), the mean difference was -2.31° (95% CI: -3.22° to -1.40°; p < 0.001).Discussion\n\nShort-leg and standing long-leg radiographs demonstrate systematic differences in postoperative coronal-alignment measurement. Although the overall mean difference was modest, the relatively wide limits of agreement indicate that larger discrepancies can occur in individual patients. Short-leg radiographs should not be considered interchangeable with standing long-leg radiographs when accurate assessment of the lower-limb mechanical axis is required.",
  "abstract_shown": true,
  "affiliations": [
    "Steve Biko Academic Hospital, Pretoria, South Africa.",
    "Dr. George Mukhari Academic Hospital, Ga-Rankuwa, South Africa.",
    "University of Pretoria, South Africa.",
    "Steve Biko Academic Hospital and Life Faerie Glen Hospital, Pretoria, South Africa."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Rory Schanknecht",
      "orcid": "0009-0000-7683-3496"
    },
    {
      "affs": [
        0
      ],
      "name": "Carel Willemse"
    },
    {
      "affs": [
        0
      ],
      "name": "Bakatuasa Freddy Mulunda"
    },
    {
      "affs": [
        1
      ],
      "name": "Adriaan de Villiers"
    },
    {
      "affs": [
        2
      ],
      "name": "Gopika Ramkilawon"
    },
    {
      "affs": [
        3
      ],
      "name": "Hans Jacobs"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e2ndmjxj1qj1t.bib",
  "cited_by": 0,
  "doi": "10.1051/sicotj/2026079",
  "fulltext_url": "https://europepmc.org/articles/PMC13707266",
  "id": "e2ndmjxj1qj1t",
  "issns": [
    "2426-8887"
  ],
  "landing_url": "https://europepmc.org/article/MED/42932858",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Total Knee Arthroplasty Outcomes"
    ]
  ],
  "openalex": "W7223666560",
  "pdf_url": "https://europepmc.org/articles/PMC13707266?pdf=render",
  "pmcid": "PMC13707266",
  "pmid": "42932858",
  "published": "2026-10-26",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/e2ndmjxj1qj1t.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:01Z",
      "native_id": "MED:42932858",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42932858"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Total Knee Arthroplasty Outcomes",
      "subfield": "surgery"
    }
  ],
  "title": "Comparison of coronal alignment measured on postoperative short-leg and standing long-leg radiographs following total knee arthroplasty.",
  "title_text": "Comparison of coronal alignment measured on postoperative short-leg and standing long-leg radiographs following total knee arthroplasty.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:01Z",
  "url": "https://research.draconitic.com/paper/e2ndmjxj1qj1t",
  "venue": "SICOT-J",
  "versions": []
}