Evidence map›Paper›PMID 39731584›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Comparing supine CT scanogram and standing long-leg radiograph for postoperative alignment in total knee arthroplasty: a prospective study.

Vikram Arun Mhaskar, Rachit Saggar, Satyabrat Karan, Jitendra Maheshwari

Abstract readComparative Study
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In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Vikram Arun MhaskarSitaram Bhartia Institute of Science and Research, New Delhi, India. drvikrammhaskar@gmail.com.
Rachit SaggarVardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India. saggarrachit15@gmail.com.
Satyabrat KaranMax Super Speciality Hospital, Delhi, India.
Jitendra MaheshwariSitaram Bhartia Institute of Science and Research, New Delhi, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAchieving precise postoperative alignment is critical for the long-term success of total knee arthroplasty (TKA). Long-leg standing radiograph (LLR) at 6 weeks post-op is the gold standard for assessing alignment, but its reliance on weight-bearing and positioning makes it less practical in the early postoperative period. Supine computed tomography scanogram (CTS) offers a potential alternative. This study compares CTS and LLR in patients undergoing TKA with patient-specific valgus correction angles (VCA).

methodsA prospective study of 108 knees from 57 patients undergoing primary TKA was conducted. CTS was performed on postoperative day three in a supine non-weight-bearing position, and LLR at six weeks in an upright standing position. Coronal alignment was assessed using hip-knee-ankle angle (HKA) and compared using Bland-Altman plots, paired-samples t-tests, and Cohen's d.

resultsCTS showed 57% of knees were within 3° of neutral alignment, while LLR showed 61%. The mean difference between modalities was 0.52° (SD, 3.56°; p = 0.07). Inter-observer reliability was excellent for both CTS and LLR (all ICCs > 0.9).

conclusionWhile CTS provides a useful alternative for early postoperative alignment assessment-particularly in situations where a standing LLR is not feasible-the observed variability suggests that LLR remains the more reliable modality when precise alignment is critical. Surgeons should therefore consider CTS as an adjunct tool for early decision-making or non-ambulatory patients in the immediate postoperative setting. LEVEL OF EVIDENCE: Level II, Prospective Comparative Study.

Indexed as

Arthroplasty, Replacement, KneeStanding PositionTomography, X-Ray ComputedAgedAged, 80 and overFemaleHumansKnee JointMaleMiddle AgedPostoperative PeriodProspective StudiesSupine PositionComputed tomographyKnee arthroplastyMechanical alignmentPatient-specific instrumentationX-Ray

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.