Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2024 May 1;110(5):2583-2592.
doi: 10.1097/JS9.0000000000001178.

Distribution of coronal plane alignment of the knee classification in Chinese osteoarthritic and healthy population: a retrospective cross-sectional observational study

Yu-Hang Gao  1 , Yu-Meng Qi  2 , Pei-Hong Huang  1 , Xing-Yu Zhao  1 , Xin Qi  1
Affiliations
Observational Study

Distribution of coronal plane alignment of the knee classification in Chinese osteoarthritic and healthy population: a retrospective cross-sectional observational study

Yu-Hang Gao et al. Int J Surg. .

Abstract

Background: Few studies have reported the coronal constitutional alignment of the lower limbs in mainland China. This study aimed to analyse the distribution of the coronal plane alignment of the knee (CPAK) classification in the osteoarthritic (OA) and healthy Chinese populations.

Materials and methods: The CPAK distributions of 246 patients (477 knees) with OA and 107 healthy individuals (214 knees) were retrospectively examined using long-leg radiographs. Radiological measurements and CPAK classification of different Kellgren-Lawrence grades in patients with unilateral total knee arthroplasty (TKA) were compared. The clinical outcomes of patients with CPAK type I who underwent mechanical alignment or restricted kinematic alignment during TKA were examined.

Results: The most common distributions in the OA and healthy groups were type I and type II, respectively. In patients who underwent unilateral TKA, the most common distribution of knees graded as Kellgren-Lawrence 3-4 was type I. However, the most common distributions of contralateral knees graded as Grade 0-2 were type I and II. For patients with CPAK type I, the mechanical alignment and restricted kinematic alignment groups did not differ significantly concerning postoperative clinical outcomes at 3 months.

Conclusion: The most common distributions in Chinese osteoarthritic and healthy populations were types I and II, respectively. In addition, OA progression may lead to changes in the CPAK classification.

Trial registration: ClinicalTrials.gov NCT06158425.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Plot of arithmetic hip-knee-ankle angle (aHKA) against joint line obliquity for an arthritic population, showing the distribution by percentage in the nine coronal plane alignments of the knee types. LDFA, lateral distal femoral angle; MPTA, medial proximal tibial angle.
Figure 2
Figure 2
Plot of the arithmetic hip-knee-ankle angle (aHKA) against joint line obliquity for a healthy population, showing the distribution by percentage in the nine coronal plane alignments of the knee types. LDFA, lateral distal femoral angle; MPTA, medial proximal tibial angle.
Figure 3
Figure 3
Plot of the arithmetic hip-knee-ankle angle (aHKA) against joint line obliquity for knees with Kellgren–Lawrence 3–4 in patients undergoing unilateral TKA, showing the distribution by percentage in the nine coronal plane alignment of the knee types. LDFA, lateral distal femoral angle; MPTA, medial proximal tibial angle.
Figure 4
Figure 4
Plot of the arithmetic hip-knee-ankle angle (aHKA) against joint line obliquity for contralateral knees with Kellgren–Lawrence 0–2 in patients undergoing unilateral TKA, showing the distribution by percentage in the nine coronal plane alignment of the knee types. LDFA, lateral distal femoral angle; MPTA, medial proximal tibial angle.
See this image and copyright information in PMC

References

    1. Bellemans J, Colyn W, Vandenneucker H, et al. . The Chitranjan Ranawat award: is neutral mechanical alignment normal for all patients? The concept of constitutional varus. Clin Orthop Relat Res 2012;470:45–53. - PMC - PubMed
    1. Howell SM, Howell SJ, Kuznik KT, et al. . Does a kinematically aligned total knee arthroplasty restore function without failure regardless of alignment category? Clin Orthop Relat Res 2013;471:1000–1007. - PMC - PubMed
    1. MacDessi SJ, Oussedik S, Abdel MP, et al. . The language of knee alignment: updated definitions and considerations for reporting outcomes in total knee arthroplasty. Bone Joint J 2023;105-B:102–108. - PubMed
    1. Lin YH, Chang FS, Chen KH, et al. . Mismatch between femur and tibia coronal alignment in the knee joint: classification of five lower limb types according to femoral and tibial mechanical alignment. BMC Musculoskelet Disord 2018;19:411. - PMC - PubMed
    1. Hirschmann MT, Moser LB, Amsler F, et al. . Functional knee phenotypes: a novel classification for phenotyping the coronal lower limb alignment based on the native alignment in young non-osteoarthritic patients. Knee Surg Sports Traumatol Arthrosc 2019;27:1394–1402. - PubMed

Publication types

Associated data