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Tissue Collection and RNA Extraction from the Human Osteoarthritic Knee Joint
Published on: July 22, 2021
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Are there differences in phenotypes between Asian and Caucasian osteoarthritic knees?
Arun B Mullaji1, Sitaram Chopperla1, Anand Gupta1
1Breach Candy Hospital, Mumbai, India.
Journal of Orthopaedics
|November 17, 2025
Summary
This study analyzed Coronal Plane Alignment of Knee (CPAK) phenotypes in 2026 Indian patients undergoing total knee arthroplasty. Varus alignment was prevalent, with CPAK Type I being the most common phenotype in this population.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Personalized alignment strategies are increasingly used in total knee arthroplasty (TKA).
- Understanding the distribution of Coronal Plane Alignment of Knee (CPAK) phenotypes in diverse populations is crucial for tailoring these strategies.
- Previous research has not extensively detailed CPAK phenotype distribution specifically within the Indian population.
Purpose of the Study:
- To determine the distribution of CPAK phenotypes in a large cohort of Indian patients with osteoarthritis.
- To establish baseline data on knee alignment variations in this demographic for personalized TKA.
- To compare the prevalence of specific CPAK types in Indian versus non-Indian populations.
Main Methods:
- Retrospective, cross-sectional analysis of 2026 preoperative standing long-leg radiographs (hip-to-ankle) from Indian osteoarthritic knees.
- Classification of each knee into one of nine CPAK types based on arithmetic Hip-Knee-Ankle angle (aHKA) and Joint Line Obliquity (JLO).
- Statistical analysis to determine the prevalence of each CPAK type and alignment parameters.
Main Results:
- A significant prevalence of varus alignment was observed, with 76% of knees showing a varus aHKA (mean 5.12°).
- The most frequent CPAK types were Type I (56.1%), Type IV (19.1%), Type II (11.3%), and Type V (6.6%).
- CPAK Type I was more prevalent in Asian populations, while CPAK Type II was more common in non-Asian populations.
Conclusions:
- The study establishes the distribution of CPAK phenotypes in Indian patients, highlighting a predominant varus alignment and specific common types.
- Findings suggest potential population-specific differences in CPAK phenotypes, with Type I being characteristic of Asian populations.
- Further longitudinal studies are recommended to investigate optimal alignment targets for personalized TKA and the benefits of restoring pre-arthritic phenotypes.
