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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Short Term Outcome of Tibial Defect Reconstruction In Primary Total Knee Arthroplasty: A Retrospective Study ePoster Presentation Sanjib Kumar Behera, MS (Orth), DNB (Rehab), DPMR, INDIA Madhumita Pradhan, BDS, MPH, MHA , INDIA Vikram Choudhary, MD, UNITED STATES
Combined Fixed-Bearing Unicompartmental Knee Arthroplasty and Anterior Cruciate Ligament Reconstruction ePoster Presentation Claudio Legnani, MD, ITALY Enrico Borgo, MD, ITALY Vittorio Macchi, MD, ITALY Alberto Ventura, MD, ITALY
Impact of Femur Correction on the Mechanical Alignment of the Total Knee Prosthesis ePoster Presentation Israel Alejandro Alejandro González Rizo, MD, MEXICO Fidel G Dobarganes, Prof, MEXICO Jorge Negrete Corona, MD, MEXICO Alberto Guevara-Alvarez, MD, MEXICO Franco Garcini Munguia, MD, MEXICO
Bicruciate Substituting Total Knee Arthroplasty Improved Anteroposterior Displacement in Mid-Flexion Range ePoster Presentation Keinosuke Ryu, Prof., JAPAN Takanori Iriuchisima, MD, JAPAN
Comparison of Outcomes between Fungal and Non-fungal Periprosthetic Joint Infections in Total Knee Arthroplasty: A Propensity Score-Matched Analysis ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Subtalar Joint Compensation using Full-length Standing Lower Extremity Anteroposterior Radiograph after Total Knee Arthroplasty for Varus Osteoarthritis in Nara Medical University Hospital with 2-year Follow-up ePoster Presentation Jerre Co De Guzman, MD, PHILIPPINES Munehiro Ogawa, MD, PhD, JAPAN Yusuke Ozaki, MD, JAPAN Yasuhito Tanaka, Prof., JAPAN Yuki Nishimura, MD, JAPAN Maria Elizabeth Mercado, MD, MAS, PHILIPPINES
How to Measure Physical Function in Clinical Trials on Patients Undergoing Total or Partial Knee Arthroplasty? A Systematic Review ePoster Presentation Marco Adriani, MD, ITALY Roland Becker, MD, PhD, Prof., GERMANY Aleksandra Krolikowska, PhD, Prof., POLAND Krzysztof Lachowski, MD, GERMANY Robert Prill, PhD, GERMANY
Effect of Altered Knee Joint Loading Pattern in Gait Biomechanics of Total Knee Arthroplasty Patient ePoster Presentation Sang Jin Lee, MD, PhD, KOREA, REPUBLIC OF
Total Knee Arthroplasty Without Patellar Component Replacement. Does it Increase the Risk of Revision? Local Experience Analysis ePoster Presentation Zoy Anastasiadis, MD, CHILE Diego Edwards, MD, CHILE Sergio Arellano, MD, CHILE Andrés Schmidt-Hebbel, MD, CHILE Eduardo Gardella, MD, CHILE Nicolás González-Kusjanovic, MD, MSc, CHILE Alex Vaisman, MD, Prof., CHILE
Intra- And Inter-Operator Reliability Assessment Of A Novel Extramedullary Accelerometer-Based Smart Cutting-Guide For Total Knee Arthroplasty: An In-Vivo Study ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Arcangelo Russo, MD, ITALY Mirco Lo Presti, MD, ITALY Iacopo Sassoli, MD, ITALY Matteo La Verde, MD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
Knee Arthroscopy Prior to UKA Does Not Cause Infection ePoster Presentation Kevin D. Plancher, MD, MPH, UNITED STATES Karen Briggs, MPH, UNITED STATES Stephanie C. Petterson, MPT, PhD, 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

Objective

Method

Results

Discussion

More 2023 ISAKOS Congress Content