Gender, BMI, and Age‐Related Variations in Lower Limb Alignment Parameters and CPAK Phenotypes in Chinese Patients with Knee Osteoarthritis

Objectives Research on the distribution of and the variation in coronal plane alignment of the knee (CPAK) in the Chinese osteoarthritis population is limited. We aimed to establish the CPAK classification based on the characteristics of lower limb alignment in the Chinese osteoarthritis population....

Full description

Saved in:
Bibliographic Details
Main Authors: Songlin Li, Xi Chen, Sen Liu, Hongjun Xu, Yang Yu, Shanni Li, Zhaojing Yin, Yiyang Du, Miaomiao Zhang, Peilai Liu, Wenwei Qian
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Orthopaedic Surgery
Subjects:
Online Access:https://doi.org/10.1111/os.14253
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846146926023540736
author Songlin Li
Xi Chen
Sen Liu
Hongjun Xu
Yang Yu
Shanni Li
Zhaojing Yin
Yiyang Du
Miaomiao Zhang
Peilai Liu
Wenwei Qian
author_facet Songlin Li
Xi Chen
Sen Liu
Hongjun Xu
Yang Yu
Shanni Li
Zhaojing Yin
Yiyang Du
Miaomiao Zhang
Peilai Liu
Wenwei Qian
author_sort Songlin Li
collection DOAJ
description Objectives Research on the distribution of and the variation in coronal plane alignment of the knee (CPAK) in the Chinese osteoarthritis population is limited. We aimed to establish the CPAK classification based on the characteristics of lower limb alignment in the Chinese osteoarthritis population. We also investigated variations in lower limb alignment parameters and CPAK phenotypes based on gender, body mass index (BMI), and age. Methods A retrospective study was conducted on a total of 944 knees diagnosed with osteoarthritis in 479 patients from January 2017 to December 2023. A scatterplot was used to describe the distribution of the CPAK classification, and the differences in lower limb alignment parameters and the CPAK classification were compared across genders (male, female), ages (middle‐aged/<65 years, elderly/≥65 years), and BMI categories (normal/<25 kg/m2, overweight and obese/≥25 kg/m2) using the chi‐squared test or Fisher's exact test. Results The average arithmetic hip‐knee‐ankle angle and joint line obliquity (JLO) were −3.03° ± 5.69° and 174.45° ± 4.29°, respectively. There was a higher prevalence of constitutional varus alignment in males and the overweight or obese group, while constitutional valgus alignment was more common in females and the normal BMI group (p < 0.05). Additionally, females had a greater apex distal JLO than males (p < 0.05). There were no statistically significant differences in lower limb alignment parameters among different age groups (p > 0.05). Although there were variations in alignment parameters across different genders and BMI categories in the knee osteoarthritis population, the predominant CPAK classifications were type I (38.03%), followed by type II (20.02%) and type IV (17.06%). Conclusion The most common CPAK types were I, II, and IV, and they were not influenced by gender, BMI, or age, indicating that the CPAK classification can reliably reflect constitutional alignment. A better understanding of native alignment variability can aid in providing patient‐specific recommendations when considering orthopedic alignment strategies.
format Article
id doaj-art-e29ad9e3725b4a75958236091b0b7ab3
institution Kabale University
issn 1757-7853
1757-7861
language English
publishDate 2024-12-01
publisher Wiley
record_format Article
series Orthopaedic Surgery
spelling doaj-art-e29ad9e3725b4a75958236091b0b7ab32024-12-02T00:45:54ZengWileyOrthopaedic Surgery1757-78531757-78612024-12-0116123098310610.1111/os.14253Gender, BMI, and Age‐Related Variations in Lower Limb Alignment Parameters and CPAK Phenotypes in Chinese Patients with Knee OsteoarthritisSonglin Li0Xi Chen1Sen Liu2Hongjun Xu3Yang Yu4Shanni Li5Zhaojing Yin6Yiyang Du7Miaomiao Zhang8Peilai Liu9Wenwei Qian10Department of Orthopedics Qilu Hospital of Shandong University Jinan ChinaDepartments of Orthopedics West China Hospital, West China School of Medicine, Sichuan University Chengdu ChinaDepartment of Orthopedic Surgery Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Orthopedic Surgery Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Orthopedic Surgery Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Orthopedic Surgery Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Orthopedic Surgery Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Orthopedic Surgery Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Orthopedic Surgery Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Orthopedics Qilu Hospital of Shandong University Jinan ChinaDepartment of Orthopedic Surgery Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College Beijing ChinaObjectives Research on the distribution of and the variation in coronal plane alignment of the knee (CPAK) in the Chinese osteoarthritis population is limited. We aimed to establish the CPAK classification based on the characteristics of lower limb alignment in the Chinese osteoarthritis population. We also investigated variations in lower limb alignment parameters and CPAK phenotypes based on gender, body mass index (BMI), and age. Methods A retrospective study was conducted on a total of 944 knees diagnosed with osteoarthritis in 479 patients from January 2017 to December 2023. A scatterplot was used to describe the distribution of the CPAK classification, and the differences in lower limb alignment parameters and the CPAK classification were compared across genders (male, female), ages (middle‐aged/<65 years, elderly/≥65 years), and BMI categories (normal/<25 kg/m2, overweight and obese/≥25 kg/m2) using the chi‐squared test or Fisher's exact test. Results The average arithmetic hip‐knee‐ankle angle and joint line obliquity (JLO) were −3.03° ± 5.69° and 174.45° ± 4.29°, respectively. There was a higher prevalence of constitutional varus alignment in males and the overweight or obese group, while constitutional valgus alignment was more common in females and the normal BMI group (p < 0.05). Additionally, females had a greater apex distal JLO than males (p < 0.05). There were no statistically significant differences in lower limb alignment parameters among different age groups (p > 0.05). Although there were variations in alignment parameters across different genders and BMI categories in the knee osteoarthritis population, the predominant CPAK classifications were type I (38.03%), followed by type II (20.02%) and type IV (17.06%). Conclusion The most common CPAK types were I, II, and IV, and they were not influenced by gender, BMI, or age, indicating that the CPAK classification can reliably reflect constitutional alignment. A better understanding of native alignment variability can aid in providing patient‐specific recommendations when considering orthopedic alignment strategies.https://doi.org/10.1111/os.14253arthroplastyCPAKknee alignmentknee osteoarthritis
spellingShingle Songlin Li
Xi Chen
Sen Liu
Hongjun Xu
Yang Yu
Shanni Li
Zhaojing Yin
Yiyang Du
Miaomiao Zhang
Peilai Liu
Wenwei Qian
Gender, BMI, and Age‐Related Variations in Lower Limb Alignment Parameters and CPAK Phenotypes in Chinese Patients with Knee Osteoarthritis
Orthopaedic Surgery
arthroplasty
CPAK
knee alignment
knee osteoarthritis
title Gender, BMI, and Age‐Related Variations in Lower Limb Alignment Parameters and CPAK Phenotypes in Chinese Patients with Knee Osteoarthritis
title_full Gender, BMI, and Age‐Related Variations in Lower Limb Alignment Parameters and CPAK Phenotypes in Chinese Patients with Knee Osteoarthritis
title_fullStr Gender, BMI, and Age‐Related Variations in Lower Limb Alignment Parameters and CPAK Phenotypes in Chinese Patients with Knee Osteoarthritis
title_full_unstemmed Gender, BMI, and Age‐Related Variations in Lower Limb Alignment Parameters and CPAK Phenotypes in Chinese Patients with Knee Osteoarthritis
title_short Gender, BMI, and Age‐Related Variations in Lower Limb Alignment Parameters and CPAK Phenotypes in Chinese Patients with Knee Osteoarthritis
title_sort gender bmi and age related variations in lower limb alignment parameters and cpak phenotypes in chinese patients with knee osteoarthritis
topic arthroplasty
CPAK
knee alignment
knee osteoarthritis
url https://doi.org/10.1111/os.14253
work_keys_str_mv AT songlinli genderbmiandagerelatedvariationsinlowerlimbalignmentparametersandcpakphenotypesinchinesepatientswithkneeosteoarthritis
AT xichen genderbmiandagerelatedvariationsinlowerlimbalignmentparametersandcpakphenotypesinchinesepatientswithkneeosteoarthritis
AT senliu genderbmiandagerelatedvariationsinlowerlimbalignmentparametersandcpakphenotypesinchinesepatientswithkneeosteoarthritis
AT hongjunxu genderbmiandagerelatedvariationsinlowerlimbalignmentparametersandcpakphenotypesinchinesepatientswithkneeosteoarthritis
AT yangyu genderbmiandagerelatedvariationsinlowerlimbalignmentparametersandcpakphenotypesinchinesepatientswithkneeosteoarthritis
AT shannili genderbmiandagerelatedvariationsinlowerlimbalignmentparametersandcpakphenotypesinchinesepatientswithkneeosteoarthritis
AT zhaojingyin genderbmiandagerelatedvariationsinlowerlimbalignmentparametersandcpakphenotypesinchinesepatientswithkneeosteoarthritis
AT yiyangdu genderbmiandagerelatedvariationsinlowerlimbalignmentparametersandcpakphenotypesinchinesepatientswithkneeosteoarthritis
AT miaomiaozhang genderbmiandagerelatedvariationsinlowerlimbalignmentparametersandcpakphenotypesinchinesepatientswithkneeosteoarthritis
AT peilailiu genderbmiandagerelatedvariationsinlowerlimbalignmentparametersandcpakphenotypesinchinesepatientswithkneeosteoarthritis
AT wenweiqian genderbmiandagerelatedvariationsinlowerlimbalignmentparametersandcpakphenotypesinchinesepatientswithkneeosteoarthritis