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This study investigated the accuracy and reliability of using full-length lower limb radiographs to measure alignment outcomes of computer-assisted total knee arthroplasty. Simulated radiographs were created from cadaveric whole leg CT scans. Three analysts performed repeated measurement of the hip-knee-ankle (HKA) angle, blinded to the ID of the subject and image repetition. In addition, simulated radiographs with internal/externallimb rotation were measured to assess sensitivity of the measurements. The result demonstrated high accuracy and reliability of the measurement, with low sensitivity to limb rotation. The findings supported the use of full-length lower limb radiographs to measure clinical outcomes in HKA.

Accuracy and reliability of full-length lower limb radiographs in the measurement of coronal alignment