Phruetthiphat Ong-Art, Pinijprapa Panukorn, Uthaicharatratsame Charoenwat
Phramongkutklao Hospital, Bangkok, Thailand.
Nopparat Rajathanee Hospital, Bangkok, Thailand.
J Orthop Surg Res. 2024 Dec 26;19(1):879. doi: 10.1186/s13018-024-05380-w.
Understanding optimal prosthesis alignment in TKA remains crucial despite ongoing debate. While current research focuses on osteoarthritic knees, a gap exists in characterizing healthy young adult knees in Asians. This study aims to fill this gap by identifying the distribution of CPAK phenotypes in this population, including potential gender variations and individual differences.
A total of 390 knees from 195 young adults aged 20 to 35 years without knee pain who underwent hip-knee-ankle radiography were prospectively collected between February 2024 and March 2024. The average MPTA, LDFA, aHKA, and JLO were measured. The overall CPAK distribution was analyzed to assess gender variations and individual differences. On average, participants were 25.7 years old, 165.7 cm tall, and had a BMI of 23.6 kg/m². LDFA, MPTA, aHKA, and JLO averaged at 86.8°, 87.2°, 0.3°, and 174.0°, respectively.
This study demonstrates significant differences in knee alignment between men and women, as measured by the CPAK system. While zone II was the most common overall (43.3%), the distribution of CPAK zones varied by gender, with men exhibiting a higher prevalence of distal apex point alignments (89.9%) and women having a higher prevalence of CPAK zone V (18.3%). Finally, analysis of paired knees revealed a comparable zonal distribution for both genders (approximately 56%).
This study examined CPAK distribution in young Asian adults without knee osteoarthritis and identified potential sex-based variations. The findings suggest a predominance of distally pointed CPAK (76.9%) and a possible benefit for slightly varus tibial cuts during TKA in this population for optimal joint alignment. Additionally, gender-specific considerations should be incorporated into knee alignment assessments and treatment planning.
II, A prospective descriptive study.
尽管仍存在争议，但了解全膝关节置换术（TKA）中假体的最佳对线仍然至关重要。虽然目前的研究主要集中在骨关节炎膝关节，但在描述亚洲健康年轻成年人的膝关节特征方面存在空白。本研究旨在通过确定该人群中CPAK表型的分布，包括潜在的性别差异和个体差异，来填补这一空白。
在2024年2月至2024年3月期间，前瞻性收集了195名年龄在20至35岁之间无膝关节疼痛的年轻成年人的390个膝关节的髋-膝-踝关节X线片。测量了平均机械轴胫骨角（MPTA）、外侧远端股骨角（LDFA）、解剖学股胫角（aHKA）和关节线倾斜度（JLO）。分析了CPAK的总体分布，以评估性别差异和个体差异。参与者的平均年龄为25.7岁，身高165.7厘米，体重指数（BMI）为23.6千克/平方米。LDFA、MPTA、aHKA和JLO的平均值分别为86.8°、87.2°、0.3°和174.0°。
本研究表明，通过CPAK系统测量，男性和女性的膝关节对线存在显著差异。虽然II区总体上是最常见的（43.3%），但CPAK区的分布因性别而异，男性远端顶点对线的患病率较高（89.9%），而女性CPAK V区的患病率较高（18.3%）。最后，对成对膝关节的分析显示，两性的分区分布具有可比性（约56%）。
本研究检查了无膝关节骨关节炎的亚洲年轻成年人的CPAK分布，并确定了潜在的性别差异。研究结果表明，在该人群中，远端指向性CPAK占主导地位（76.9%），在TKA期间进行轻微内翻胫骨截骨可能有利于实现最佳关节对线。此外，在膝关节对线评估和治疗计划中应纳入性别特异性考虑因素。
II，前瞻性描述性研究。
