Summary: CPAK Type I was the most common classification in Japanese osteoarthritis patients (70.4%). KA-TKA preserve JLO while maintaining ligament balance. These features may contribute to the results of KA-TKA.

Objective

The coronal plane alignment of the knee (CPAK) classification is a coronal plane alignment classification consisting of nine phenotypes based on joint obliquity and lower limb alignment. In this study, we examined the changes in CPAK classification and its characteristics before and after surgery in Kinematic alignment (KA) TKA.

Method

Twenty-seven knees (male:female = 3:24, mean age 76) who underwent True KA-TKA from September 2021 to July 2022 were included. The aHKA (arithmetic HKA = MPTA-LFDA: varus < -2°, neutral = 0±2°, valgus > 2°) and JLO (joint line obliquity = MPTA + LFDA: apex distal<177°, neutral=180±3°, apex proximal>183°) were measured from long leg radiographs before and after surgery, and the lower limb alignment was classified based on the combination of these measurements. The frequency of each CPAK phenotypes and pre- and postoperative changes were examined.

Results

The pre- and postoperative changes in CPAK classification were Type I; 70.4% to 44.4%, II; 11.1% to 29.6%, III; 7.4% to 11.1%, IV; 11.1% to 11.1%, V; 0% to 3.7%, and VI to IX; 0% to 0%. The changes in aHKA were varus; 81.5% to 55.6%, neutral; 11.1% to 33.3%, and valgus; 7.4% to 11.1%, and the changes in JLO were apex distal; 88.9% to 85.2%, neutral; 11.1% to 14.8%, and proximal; 0% to 0%. JLO was preserved in 96.3% of the cases.

Discussion

According to a previous report (Toyooka, 2022), Type I was the most common CPAK classification in Japanese patients with knee osteoarthritis (53.8%), and similarly Type I was the most common in the present study (70.4%). KA-TKA was characterized by the preservation of JLO.
In Japanese patients with strong varus deformity, mechanical alignment technique often requires excessive soft tissue dissection to achieve neutral alignment and JLO, whereas KA technique preserve JLO while maintaining ligament balance. Many favorable clinical results of the KA-TKA have been reported in recent years, and these features in this study may contribute to the clinical results of the KA-TKA.

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Efficacy of Functional Alignment Technique In Robotic-Arm Assisted Total Knee Arthroplasty ePoster Presentation Masashi Tamaki, MD, PhD, JAPAN Yuki Yamauchi, MD,PhD, JAPAN Seishiro Higa, MD, JAPAN Tomoyuki Shimakawa, MD, JAPAN Yuki Isobe, MD, JAPAN Teruya Ishibashi, MD,PhD, JAPAN Shoji Konda, PhD, JAPAN Tetsuya Tomita, M.D.,Ph.D , JAPAN
Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Relationship Between The Femoral And Tibial Component Positions And Postoperative Knee Range Of Motion After Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA ePoster Presentation Daisuke Hamada, MD, PhD, JAPAN Keizo Wada, MD, JAPAN Yasuaki Tamaki, MD, JAPAN Yasuyuki Omichi, MD, JAPAN Tomohiro Goto, MD, PhD, JAPAN Koichi Sairyo, MD, PhD, JAPAN
Hip-Knee-Ankle Angle Affects Medial and Lateral Tibiofemoral Compressive Forces More Significantly than Joint Line Obliquity in Patients Post Total Knee Arthroplasty ePoster Presentation David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA Myles R. J. Coolican, FRACS, AUSTRALIA Brett A. Fritsch, MBBS BSc(Med), FRACS, FAOrthA, AUSTRALIA Alexander S. Nicholls, MSc, FRACS, AUSTRALIA Payam Tarassoli, MBChB, BSc, DipSEM, MD, FRCS, AUSTRALIA Yoong Lim, BEng, PhD, AUSTRALIA
Is Surgeon Assessed Bone Quality During Total Knee Arthroplasty a Valid Tool To Diagnose Osteoporosis ? ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Arpit Vasantbhai Bavaskar, MBBS, D.Orth., INDIA Vishal Raina, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Ashwini Khokhar, MS, INDIA Rajesh Maniar, INDIA
The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty ePoster Presentation Simon W. Young, MD, FRACS, NEW ZEALAND Matthew Carter, NEW ZEALAND Gavin William Clark, MBBS, FRACS, AUSTRALIA Christina Esposito, PhD, AUSTRALIA Matthew Walker, MBChB, FRACS, NEW ZEALAND
No Difference In Sports Participation And Patient-Reported Functional Outcomes Between Total Knee Arthroplasty And Unicompartmental Knee Arthroplasty At Minimum 2-Year Follow-Up In A Matched Control Study ePoster Presentation Amit Meena, MBBS, MS, DNB, INDIA Elisabeth Abermann, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Luca Farinelli, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Akshya Raj, MBBS,MS, INDIA Mohit Kumar Patralekh, MBBS, MS(Orthopaedics), DNB(Orthopaedics), MNAMS, INDIA Christian Fink, MD, Prof., AUSTRIA
Combined Single-Shot Infiltration Between the Popliteal Artery and Capsule of the Knee and Adductor Canal Block with Bupivacaine, Dexmedetomidine, and Dexamethasone for Total Knee Arthroplasty: A Propensity-Matched Analysis ePoster Presentation David Freccero, MD, UNITED STATES Aneesh V Samineni, BA, UNITED STATES Seroos Salavati, MD, UNITED STATES

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Changes In CPAK Classification and Its Characteristics before and after Kinematic Alignment TKA

Changes In CPAK Classification and Its Characteristics before and after Kinematic Alignment TKA

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Changes In CPAK Classification and Its Characteristics before and after Kinematic Alignment TKA

Changes In CPAK Classification and Its Characteristics before and after Kinematic Alignment TKA

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More 2023 ISAKOS Congress Content