Posterior tibial slope varies across functional tibial phenotypes but not CPAK categories: A radiographic analysis from the FP-UCBM Knee Study Group

IF 5.5 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2026-07-02 Epub Date: 2025-10-28 DOI:10.1002/ksa.70135

Edoardo Franceschetti, Giancarlo Giurazza, Alessandro Del Monaco, Marco Spatuzzi, Stefano Campi, Andrea Tanzilli, Pietro Gregori, Matteo Formica, Michele Paciotti, Rocco Papalia

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引用次数: 0

Abstract

Purpose

The relationship between the coronal and sagittal planes of the knee remains largely unexplored. The aim of this study was to evaluate the correlation between Posterior Tibial Slope (PTS), Hirschmann's functional tibial phenotypes, CPAK categories, and their defining parameters, hypothesising that coronal and sagittal tibial parameters are interrelated.

Methods

A retrospective analysis was conducted on preoperative radiographs from 204 patients (217 knees) undergoing primary TKA for end-stage osteoarthritis between January 2023 and September 2023. PTS was measured on weight-bearing true lateral radiographs with strict quality criteria. Coronal alignment variables—including arithmetic Hip-Knee-Ankle Angle (aHKA), Joint Line Obliquity (JLO) and Tibial Mechanical Angle (TMA)—were derived from full-length standing radiographs, and CPAK categories and functional tibial phenotypes were assigned accordingly. Statistical analysis included Kruskal–Wallis tests and Spearman's correlations. Statistical significance was set at p < 0.05.

Results

No significant differences in PTS were observed across CPAK categories (p = 0.501), aHKA categories (p = 0.103), or JLO categories (p = 0.906). In contrast, PTS differed significantly among functional tibial phenotypes (p = 0.004), with the highest values in VAR_TMA6 (8.2° ± 3.4), VAL_TMA6 (8.0° ± 2.7), and NEU_TMA0 (7.7° ± 2.8), and lowest values in VAR_TMA3 (5.7° ± 2.6) and VAL_TMA3 (6.2° ± 2.1).

Conclusion

PTS varies significantly across functional tibial phenotypes but not CPAK categories, suggesting that functional tibial phenotypes may better capture sagittal alignment variability. Incorporating PTS into phenotype-based preoperative planning could help refine patient-specific strategies in total knee arthroplasty.

Level of Evidence

Level IV.

Abstract Image

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胫骨后坡随胫骨功能表型而变化，而不是CPAK类别：FP-UCBM膝关节研究组的放射学分析。

目的：膝关节冠状面和矢状面之间的关系在很大程度上仍未被探索。本研究的目的是评估胫骨后坡（PTS）、Hirschmann's胫骨功能表型、CPAK分类及其定义参数之间的相关性，并假设冠状面和矢状面胫骨参数是相互关联的。方法：回顾性分析2023年1月至2023年9月期间接受终末期骨关节炎原发性TKA的204例患者（217例膝关节）的术前x线片。PTS在负重真侧位片上测量，具有严格的质量标准。冠状面对齐变量——包括算术髋关节-膝关节-踝关节角（aHKA）、关节线倾角（JLO）和胫骨机械角（TMA）——来自全长站立x线片，并据此分配CPAK类别和胫骨功能表型。统计分析包括Kruskal-Wallis检验和Spearman相关性。结果：6 CPAK分型（p = 0.501）、aHKA分型（p = 0.103）、JLO分型（p = 0.906）的PTS差异均无统计学意义。相比之下，不同功能胫骨表型的PTS差异显著（p = 0.004），其中VARTMA6（8.2°±3.4）、VALTMA6（8.0°±2.7）和NEUTMA0（7.7°±2.8）的PTS值最高，VARTMA3（5.7°±2.6）和VALTMA3（6.2°±2.1）的PTS值最低。结论：PTS在不同的胫骨功能表型中有显著差异，但在CPAK类别中没有显著差异，这表明功能性胫骨表型可能更好地捕捉到矢状面排列变异性。将PTS纳入基于表型的术前计划有助于完善全膝关节置换术患者特异性策略。证据等级：四级。

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

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).