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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Intraoperative Surgeon-Performed vs. Conventional Anesthesiologist-Performed Continuous Adductor Canal Block In Total Knee Arthroplasty: A Randomized Controlled Trial ePoster Presentation Chayut Chaiperm, MD, THAILAND Srihatach Ngarmukos, MD, THAILAND Aree Tanavalee, MD, THAILAND Chotetawan Tanavalee, MD, THAILAND Wirinaree Kampitak, MD, THAILAND
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
Modular Knee Arthrodesis as Definitive Treatment for Periprosthetic Infection, Bone Loss, and Failure of the Extensor Mechanism after Total Knee Arthroplasty ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Maksym Bartashevskyy, BA, UNITED STATES Zachary Berliner, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES James V. Bono, MD, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES
Accuracy of Advanced Active Robotic Technology for Total Knee Arthroplasty: A Cadaveric Study ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF
Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees ePoster Presentation Shinichiro Nakamura, MD, PhD, JAPAN Shota Takemoto, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Hiromu Ito, MD, PhD, JAPAN Mutsumi Watanabe, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Shuichi Matsuda, MD, PhD, JAPAN
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
Three-Dimensional Evaluation of Distal Femoral Valgus Angle Using Whole Leg CT in Total Knee Arthroplasty ePoster Presentation Atsushi Sato, MD, PhD, JAPAN Jun Oike, MD, PhD, JAPAN Masataka Ota, MD, JAPAN Kanako Izukashi, MD, JAPAN Saki Yagura, MD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Naoki Okuma, MD, JAPAN Takayuki Koya, MD, PhD, JAPAN Fumiyoshi Kawashima, MD, JAPAN Hiroshi Takagi, MD, PhD, JAPAN Koji Kanzaki, Prof., 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
Large Reduction In Postoperative Posterior Tibial Slope Risks Anterior Collapse Of The Tibial Component In Fixed-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Kazuhisa Hatayama, MD, PhD, JAPAN Masanori Terauchi, MD, JAPAN Shingo Kurihara, MD, JAPAN Satoshi Nonaka, MD, JAPAN Hibiki Kakiage, MD, JAPAN
Tibia Placement Difference Between The Supine And Prone Position After Total Knee Arthroplasty: The Comparison Of The BCS and PS-TKA ePoster Presentation Takanori Iriuchishima, MD, PhD, JAPAN Keinosuke Ryu, Prof., JAPAN Eiji Cho, MD, JAPAN

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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