Phenotyping of the Turkish population according to Coronal Plane Alignment of the Knee classification: A retrospective cross-sectional study

Şenel, Ahmet; Eren, Murat; Sert, Selman; Gürpınar, Tahsin; Çarkçı, Engin; Polat, Barış

doi:10.52312/jdrs.2023.1464

Cited by 5 publications

(1 citation statement)

References 23 publications

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“…In the present study, CPAK types 7 and 8 each accounted for only 1.0% of the total number of patients, while CPAK type 9 only accounted for 0.8% (Figure 1). This is in line with the findings of other authors who applied the CPAK classification to their study cohort [27,36]. In fact, CPAK type 7, 8 and 9 were even rarer, if not absent, in some studies [13,38].…”

Section: Discussionsupporting

confidence: 91%

Significant difference in femoral torsion between coronal plane alignment of the knee type 1 and 4

Ziegenhorn,

Kirschberg,

Heinecke

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe purpose of this study was to find out whether the torsions of the femur and tibia are dependent on the coronal plane alignment of the knee (CPAK) type.MethodsFive hundred patients (1000 legs) were included, who received a whole leg standing three‐dimensional (3D) radiograph using EOS imaging (EOS Imaging, Paris, France). SterEOS software was used for digital reconstruction. Femoral and tibial torsions were determined by analysing 3D reconstructions of each leg. Femoral torsion was defined as the angle between the femoral neck axis (FNA) and the posterior condylar axis (PCA). Tibial torsion was defined as the angle between the axis tangent to the posterior part of the tibia plateau and the transmalleolar axis. Arithmetic hip–knee–ankle angle (aHKA) and joint‐line obliquity (JLO) were also determined, allowing each leg to be assigned one of nine possible phenotypes according to CPAK.ResultsThe mean femoral torsion in CPAK type 1 was significantly higher (+ 2.6° ± 0.8°) than in CPAK type 4 (p = 0.02). All other CPAK types did not differ in the degree of femoral torsions. No differences could be demonstrated for the tibial torsion.ConclusionThere is a correlation between the coronal alignment of the lower limb and femoral torsion. This may provide the basis for extending the CPAK classification beyond the coronal plane.Level of EvidenceLevel III.

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Section: Discussionsupporting

confidence: 91%

Significant difference in femoral torsion between coronal plane alignment of the knee type 1 and 4

Ziegenhorn,

Kirschberg,

Heinecke

et al. 2024

Knee surg. sports traumatol. arthrosc.

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Mechanically aligned total knee arthroplasty does not yield uniform outcomes across all coronal plane alignment of the knee (CPAK) phenotypes

Franceschetti,

Campi,

Giurazza

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposePatient dissatisfaction rates following total knee arthroplasty (TKA) reported in the literature reach 20%. The optimal coronal alignment is still under debate. The aim of this retrospective study was to compare clinical outcomes in different coronal plane alignment of the knee (CPAK) phenotypes undergoing mechanically aligned (MA) TKA. The hypothesis was that knees with preoperative varus arithmetic hip‐knee‐ankle angle (aHKA) would achieve inferior clinical outcomes after surgery compared to other aHKA categories. Additionally, another objective was to assess CPAK phenotypes distribution in the study population.MethodsA retrospective selection was made of 180 patients who underwent MA TKA from April 2021 to December 2022, with a 1‐year follow‐up. Coronal knee alignment was classified according to the CPAK classification. Clinical outcome evaluations were measured using the Knee Society Score (KSS), Oxford Knee Score (OKS), Short Form Survey 12 and Forgotten Joint Score (FJS). Differences in clinical outcomes were considered statistically significant with a p value <0 .05.ResultsPatients with varus aHKA achieved significantly inferior outcomes at final follow‐up compared to other aHKA categories in KSS pt. 1 (79.7 ± 17.2 vs. 85.6 ± 14.7; p = 0.028), OKS (39.2 ± 9.2 vs. 42.2 ± 7.2; p = 0.019) and FJS (75.4 ± 31.0 vs. 87.4 ± 22.9; p =0 .003). The most common aHKA category was the varus category (39%). The most common CPAK phenotypes were apex distal Types I (23.9%), II (22.8%) and III (13.3%).ConclusionMA TKA does not yield uniform outcomes across all CPAK phenotypes. Varus aHKA category shows significantly inferior results at final follow‐up. The most prevalent CPAK categories are varus aHKA and apex distal JLO, with phenotypes I, II and III being the most common. However, their gender distribution varies significantly.Level of EvidenceLevel IV.

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Distribution of coronal plane alignment of the knee classification in Chinese osteoarthritic and healthy population: a retrospective cross-sectional observational study

Gao,

Qi,

Huang

et al. 2024

International Journal of Surgery

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Background: Few studies have reported the coronal constitutional alignment of the lower limbs in mainland China. This study aimed to analyse the distribution of the coronal plane alignment of the knee (CPAK) classification in the osteoarthritic and healthy Chinese populations. Materials and Methods: The CPAK distributions of 246 patients (477 knees) with osteoarthritis (OA) and 107 healthy individuals (214 knees) were retrospectively examined using long-leg radiographs. Radiological measurements and CPAK classification of different Kellgren–Lawrence grades in patients with unilateral total knee arthroplasty (TKA) were compared. The clinical outcomes of patients with CPAK type I who underwent mechanical alignment or restricted kinematic alignment during TKA were examined. Results: The most common distributions in the OA and healthy groups were type I and type II, respectively. In patients who underwent unilateral TKA, the most common distribution of knees graded as Kellgren–Lawrence 3–4 was type I. However, the most common distributions of contralateral knees graded as Grade 0–2 were type I and II. For patients with CPAK type I, the mechanical alignment and restricted kinematic alignment groups did not differ significantly concerning postoperative clinical outcomes at three months. Conclusion: The most common distributions in Chinese osteoarthritic and healthy populations were types I and II, respectively. In addition, OA progression may lead to changes in the CPAK classification.

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Phenotyping of the Turkish population according to Coronal Plane Alignment of the Knee classification: A retrospective cross-sectional study

Cited by 5 publications

References 23 publications

Significant difference in femoral torsion between coronal plane alignment of the knee type 1 and 4

Significant difference in femoral torsion between coronal plane alignment of the knee type 1 and 4

Mechanically aligned total knee arthroplasty does not yield uniform outcomes across all coronal plane alignment of the knee (CPAK) phenotypes

Distribution of coronal plane alignment of the knee classification in Chinese osteoarthritic and healthy population: a retrospective cross-sectional observational study

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