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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2023

17-10-2023 | Osteoarthrosis | KNEE

Knees with anteromedial osteoarthritis show a substantial phenotypic variation prior and following medial unicompartmental knee arthroplasty

Authors: G. V. ten Noever de Brauw, T. Bayoumi, L. V. Ruderman, G. M. M. J. Kerkhoffs, A. D. Pearle, H. A. Zuiderbaan

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2023

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Abstract

Purpose

The primary aim of this study was to evaluate the phenotypic variation using the Coronal Plane Alignment of the Knee (CPAK) classification among 1000 knees with anteromedial osteoarthritis (OA) both prior to and following medial unicompartmental knee arthroplasty (UKA). The secondary aim of this study was to investigate whether knees maintained their preoperative CPAK phenotype and to evaluate the phenotypic alterations following medial UKA.

Methods

The CPAK classification was used to analyze 1000 knees that underwent medial UKA as treatment for anteromedial OA. Knees were categorized into nine distinct CPAK phenotypes based on their arithmetic hip–knee–ankle angle (aHKA), which estimates the pre-arthritic alignment, and joint line obliquity (JLO), both pre- and postoperatively. Phenotypic variation was analyzed by sex and age, and the phenotypic alterations following medial UKA were evaluated by phenotype.

Results

Preoperatively, CPAK phenotype I had the highest prevalence (45.0%). Among males, the preoperative prevalence of CPAK phenotype I was significantly higher compared to females (53.2% vs. 35.0%, respectively; p ≤ .001), whereas females exhibited a significantly higher occurrence of CPAK phenotype V compared to males (9.8% vs. 4.4%, respectively; p ≤ .015). Following medial UKA, CPAK phenotype II had the highest prevalence (53.3%). Overall, 45.1% of knees maintained their preoperative CPAK phenotype following medial UKA, which was most frequently observed among CPAK phenotype II (67.7%) and III (65.8%).

Conclusion

There is a substantial variation in CPAK phenotypes among knees with anteromedial OA, as well as following treatment with medial UKA. This variability challenges the assumption of uniform characteristics among knees with an identical wear pattern associated with anteromedial OA and emphasizes the complexity and variability of this specific form of OA.

Level of evidence

III, Retrospective cohort study.
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Metadata
Title
Knees with anteromedial osteoarthritis show a substantial phenotypic variation prior and following medial unicompartmental knee arthroplasty
Authors
G. V. ten Noever de Brauw
T. Bayoumi
L. V. Ruderman
G. M. M. J. Kerkhoffs
A. D. Pearle
H. A. Zuiderbaan
Publication date
17-10-2023
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-023-07603-9

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