Preservation of preoperative CPAK is not associated with improved clinical outcomes one-year after functionally aligned robot-assisted TKA

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-01 DOI:10.1016/j.jor.2025.06.030

Oriol Pujol , Joan Minguell , Joan Pijoan , Miguel Nuño , Irene Portas-Torres , Marc Aguilar , Mercè Reverté , Martí Plomer , Enrique García-Albó , Nayana Joshi

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引用次数: 0

Abstract

Purpose

To determine if maintaining the preoperative CPAK class influences on clinical outcomes when performing a functional aligned robotic assisted TKA (RATKA).

Methods

This prospective cohort study compared patients who maintained their preoperative CPAK classification following functionally aligned RATKA with those who did not. Clinical outcomes were assed at 6 and 12 months postoperatively. Collected data included demographics variables, pain (VAS), range of motion (ROM), KOOS scores and radiographic parameters (HKA, MPTA, LDFA). JLO and aHKA values were calculated to determine CPAK classification.

Results

Fifty-five patients were included. The preoperative CPAK phenotype was preserved in 34.6 % of cases, the aHKA group in 55.6 % and the JLO group in 52.7 %. JLO preservation was significantly more frequent in distal-apex knees (90 %). Preservation of the preoperative CPAK phenotype, aHKA group or JLO group had no significant effect on knee ROM, pain or functional outcomes at 6 or 12 months postoperatively.

Conclusions

Changes in CPAK classification, aHKA or JLO during RATKA with functional alignment do not impact clinical outcomes at 6 or 12 months. Implant positioning should aim for a stable, well-balanced knee within safe positioning boundaries, rather than exact CPAK restoration.

Level of evidence

III.

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保留术前CPAK与功能对齐机器人辅助TKA术后一年临床结果的改善无关

目的探讨维持术前CPAK分级是否会影响功能性对齐机器人辅助全髋关节置换术（RATKA）的临床结果。方法本前瞻性队列研究比较了在功能对齐RATKA后维持其术前CPAK分级的患者和未维持其术前CPAK分级的患者。分别于术后6个月和12个月进行临床观察。收集的数据包括人口统计学变量、疼痛（VAS）、活动范围（ROM）、kos评分和放射学参数（HKA、MPTA、LDFA）。计算JLO和aHKA值来确定CPAK的分类。结果共纳入55例患者。术前CPAK表型保留率为34.6%，aHKA组为55.6%，JLO组为52.7%。JLO保存在远端膝关节中更为常见（90%）。保留术前CPAK表型、aHKA组或JLO组对术后6个月或12个月的膝关节ROM、疼痛或功能结局没有显著影响。结论：在功能对齐的RATKA期间，CPAK分类、aHKA或JLO的变化不会影响6个月或12个月的临床结果。植入物定位的目标应该是在安全的定位范围内实现稳定、平衡的膝关节，而不是精确的CPAK复位。证据水平ii。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.