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Related Experiment Video

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CPAK classification cannot be used to determine segmental coronal extra-articular knee deformity.

Glauco Loddo1,2, Jae-Sung An2,3, Steven Claes4

  • 1Department of Orthopaedics and Traumatology, University of Turin, Turin, Italy.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|April 21, 2024
PubMed
Summary

The Coronal Plane Alignment of the Knee (CPAK) classification does not correlate with specific extra-articular knee deformities. This finding indicates CPAK is unsuitable for determining segmental coronal extra-articular deformities in prearthritic knees.

Keywords:
coronal extra‐articular deformity phenotype (CEDP)coronal plane alignment of the knee (CPAK)kinematic alignmentmechanical alignmenttotal knee arthroplasty (TKA)

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Area of Science:

  • Orthopedic surgery
  • Radiology
  • Biomechanical analysis

Background:

  • Personalized total knee arthroplasty (TKA) relies on accurate knee alignment assessment.
  • The Coronal Plane Alignment of the Knee (CPAK) classification aids in TKA personalization.
  • The correlation between CPAK and extra-articular knee deformities requires further investigation.

Purpose of the Study:

  • To investigate the correlation between CPAK matrix groups and segmental coronal extra-articular deformities in prearthritic knees.
  • To evaluate the utility of CPAK classification in identifying specific extra-articular deformity patterns.
  • To inform personalized TKA strategies by clarifying the relationship between intra-articular and extra-articular alignment.

Main Methods:

  • Radiological assessment of 1240 nonarthritic knees using lower limb measurements.
  • Classification of knees into CPAK matrix groups.
  • Identification of nine coronal extra-articular deformity phenotype (CEDP) groups based on MPTA and mLDFA.
  • Analysis of segmental coronal extra-articular deformities within each CPAK group.

Main Results:

  • No distinct association was found between CPAK matrix groups and specific CEDP groups.
  • Significant variation in segmental coronal extra-articular deformity patterns was observed across common CPAK groups (I-V).
  • Variability in coronal extra-articular deformities increased when neutral MPTA/mLDFA values were adjusted.

Conclusions:

  • CPAK matrix groups do not directly correlate with specific extra-articular deformity patterns (CEDP).
  • CPAK classification is unsuitable for determining segmental coronal extra-articular knee deformities.
  • Further research is needed to refine alignment assessment for personalized TKA.