Comparison of a novel ‘modified full length standing hip knee ankle anteroposterior radiograph’ with the standard hindfoot alignment view radiograph for assessment of hindfoot alignment

Abstract

Background: The importance of accurate measurement of hindfoot alignment in foot and ankle pathologies is already well established. Recent evidence suggests that hindfoot alignment may also be crucial beyond foot and ankle pathologies [e.g., in total knee replacements (TKRs) and osteotomies around the knee]. Mechanical limb alignment assessment for knee surgery is usually done by a full-length standing hip-knee-ankle anteroposterior radiograph. Hindfoot, on the other hand, is currently assessed separately using specialized views (e.g., hindfoot alignment view, long axial view etc.). We hypothesized that a modified hip-knee-ankle radiograph with small adjustments will allow us to incorporate the hindfoot on the same radiograph, thus negating the need for any additional special radiographic views of the hind foot and allowing concomitantly hip-knee-ankle assessment and measurements. The aim of our study was to measure the accuracy and precision of Hindfoot alignment using our Modified Hip-Knee-Ankle radiograph in comparison to the standard hindfoot alignment view radiograph (HAV).