Journal of Orthopaedic Reports最新文献

{"title":"Calcar referenced tip apex distance (CalTAD) – A better measuring tool to assess lag screw position in pertrochanteric femur fractures treated with twin screw cephalomedullary nails","authors":"Harsha K. Kyalakond,&nbsp;Jagadish Laxmansa Katwa,&nbsp;Kiran Kumar K G","doi":"10.1016/j.jorep.2024.100530","DOIUrl":"10.1016/j.jorep.2024.100530","url":null,"abstract":"<div><h3>Background</h3><div>Literature comparing TAD and CalTAD values in twin screw cephalomedullary (CM) nails in pertrochanteric femur fractures is sparse. In twin screw CM nails, the lag screw is placed in the inferior half of femoral head to accommodate derotation screw in the upper half. As the tip of the lag screw moves away from apex of femoral head, TAD increases. There is a need for an alternative measurement method for twin screw CM nails.</div></div><div><h3>Objective</h3><div>The aim of this study was to evaluate screw position in twin screw CM nails by measuring TAD and CalTAD and analyse how these two measurements vary.</div></div><div><h3>Methods</h3><div>Postoperative radiographs of patients who underwent fixation of pertrochanteric femur fractures with twin screw CM nails were retrieved from Medsynapse PACS of our institution. TAD and CalTAD were measured in a total of 76 radiographs and the data was analysed.</div></div><div><h3>Results</h3><div>The mean TAD and CalTAD were 26.7 and 21.8 respectively. TAD was less than 25mm in 32 patients (42 %) and CalTAD was less than 25mm in 54 patients (71 %). Among 44 patients with TAD&gt;25mm, 26 patients had CalTAD&lt;25mm. Although TAD was more than 35mm in 9 patients, none of them had CalTAD more than 35mm.</div></div><div><h3>Conclusion</h3><div>In twin screw CM nails, the lag screw is placed in the inferior half of femoral head. This results in high TAD values even though screw is placed deep in the subchondral bone. For an inferiorly placed lag screw, CalTAD may be a better measuring tool to assess screw placement.</div></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100530"},"PeriodicalIF":0.0,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of surgical techniques for pediatric diaphyseal forearm fractures: A focus on titanium flexible nails versus plates and screws","authors":"Fatemeh Shahrahmani ,&nbsp;Reza Khosravi ,&nbsp;Shahab Ilka ,&nbsp;Sahar Heidarabadipour","doi":"10.1016/j.jorep.2024.100516","DOIUrl":"10.1016/j.jorep.2024.100516","url":null,"abstract":"<div><h3>Background</h3><div>Diaphyseal forearm fractures are frequently encountered in patients with immature skeletons. Proper management of these fractures is crucial for achieving the best possible outcomes. In this study, we compare two prevalent fixation methods for pediatric diaphyseal forearm fractures: plate and screw fixation versus titanium elastic nails (TEN).</div></div><div><h3>Methods</h3><div>This study was a prospective, randomized controlled trial conducted at Shahid Bahonar Hospital in Kerman, Iran. Fifty patients, aged 10–16 years, with diaphyseal fractures of the radius and ulna, were randomly assigned to one of two groups: TEN or AO–Dynamic Compression Plate (DCP). Surgical duration, length of hospitalization, and complications were assessed post-surgery. Three months post-surgery, functional outcomes and fracture union time were evaluated.</div></div><div><h3>Results</h3><div>Our study involved 50 patients with an average age of 12.1 years. The TEN group had significantly shorter surgery duration (mean 73 minutes vs. 98 minutes, p = 0.035) and hospital stay (mean 1.2 days vs. 2.1 days, p = 0.027) compared to the DCP group. No significant differences were observed in fracture union time (p = 0.73) or functional outcomes at three months (p = 0.143). Complications were minimal, with skin irritation being more common in the TEN group, while superficial wound infections were noted in the DCP group.</div></div><div><h3>Conclusion</h3><div>TEN fixation is an effective approach for pediatric diaphyseal forearm fractures, providing the advantage of shorter surgical and hospitalization times compared to plate and screw fixation methods. Additionally, the smaller incision leads to improved cosmetic results and minimizes soft tissue injury.</div></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 1","pages":"Article 100516"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical challenges of the concept of using Dual-energy X-ray absorptiometry in the management of pediatric distal radius fractures","authors":"Alireza Mobasseri","doi":"10.1016/j.jorep.2024.100525","DOIUrl":"10.1016/j.jorep.2024.100525","url":null,"abstract":"<div><div>Distal radius fractures are the most common pediatric injuries with increasing numbers in the recent years. The diagnosis of distal radius fracture is usually based on history taking, physical examination, and plain wrist radiographies. However, the radiation risk of plain X-ray imaging is its major drawback when obtaining exposures in children in their growing age. During the last few years, Dual-energy X-ray absorptiometry (DXA) scanners became more available with a highly increased resolution. This has given the opportunity for its clinical use in trauma settings. DXA scan has been associated with lower radiation exposures compared with plain radiography. Here we have reviewed possible practical challenges of its use in the management of pediatric distal radius fractures. The radiation dosage could reduce dramatically if a modified DXA scan is used in emergency setting for the diagnosis. A portable DXA machine is needed in the orthopedic operating room for evaluation of the fracture reduction and inspection of pin trajectory. Software and hardware modifications are also needed for DXA machine when it is used for follow-up visits. These changes should enhance image resolution in the presence of pin and cast. The modified DXA machine would probably result in 20–80 times less radiation exposure during the management of a routine pediatric distal radius fracture.</div></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100525"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip disarticulation for non-salvageable primary malignant sarcoma of femur: What were the oncological & functional outcomes?","authors":"Vikas Warikoo,&nbsp;Jebin Aron,&nbsp;Abhijeet Ashok Salunke,&nbsp;Nandlal Bharwani,&nbsp;Dhruv Patel,&nbsp;Anish Chowdhury,&nbsp;Arunsrinivas Muralidharan,&nbsp;Ajinkya Pawar,&nbsp;Vivek Bande,&nbsp;Shashank Pandya","doi":"10.1016/j.jorep.2024.100522","DOIUrl":"10.1016/j.jorep.2024.100522","url":null,"abstract":"<div><h3>Background</h3><div>Currently, there is limited literature available on hip disarticulation for primary malignant bone tumours. The purpose of this retrospective study is to evaluate the demographic distribution, clinical behaviour, and oncological outcomes and functional outcomes following hip disarticulation in patients with lower extremity sarcoma.</div></div><div><h3>Aims and objectives</h3><div>The current study's aims and objectives were to examine clinical behaviour, oncological outcome, prognostic variables, and quality of life in patients who underwent hip disarticulation for primary sarcoma of the femur.</div></div><div><h3>Material &amp; methods</h3><div>This study includes a retrospective examination of patients with primary femoral sarcoma who had hip articulation between May 2015 and December 2018. Neoadjuvant chemotherapy was administered to all patients with osteosarcoma and Ewing's sarcoma per institutional policy. The R0 resection had been performed on each patient. There were 24 patients with primary femur sarcoma (16 men and 8 women). The patients' median age was 28.5 years (range 11 years–70 years).</div></div><div><h3>Results</h3><div>Among 24 patients, 5 patients had distant metastasis at presentation. The computed median overall survival was 23.1 months (95 % CI:(14.76, 31.44)). Osteosarcoma, Ewing's sarcoma, and chondrosarcoma were the three most frequent cancers associated with hip disarticulation. During follow-up, thirteen patients (68.4 %) out of 19 patients suffered a recurrence. Disease-free survival was 16.97 months(95 % CI:(1.89, 32.04)). Metastatic disease at presentation was associated with a low overall survival rate. Both overall survival and disease-free survival were found to have strong positive correlation with pathological fracture at presentation. Quality of Life assessment of live patients shows reasonable ECOG and general health to maintain personal care.</div></div><div><h3>Conclusion</h3><div>Hip disarticulation is a surgical option reserved for individuals with non-salvageable tumours around the knee and hip joint. Hip disarticulation is associated with a poor prognosis, a high recurrence rate, and a low long-term survival rate. To employ emerging technology to enhance the quality of life and prosthetic limb, more research and study must be done.</div></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 1","pages":"Article 100522"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143177094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of the Copenhagen Adduction and Nordic Hamstring exercises on muscle strength and athletic performance: A quasi-experimental study","authors":"Christos Pippas ,&nbsp;Nikolaos Dagloukiaris ,&nbsp;Antonios Antypas ,&nbsp;Emmanouil Touloupis ,&nbsp;George Gioftsos","doi":"10.1016/j.jorep.2024.100524","DOIUrl":"10.1016/j.jorep.2024.100524","url":null,"abstract":"<div><h3>Background</h3><div>Two of the most common exercises used in prevention as well as rehabilitation protocols are the Nordic Hamstring (NH) and Copenhagen Adduction (CA). Although their strength effect has been investigated, the effect of the combination of both exercises on muscle strength, jump and sprint performance of male football (soccer) players has yet to be determined.</div></div><div><h3>Materials and methods</h3><div>A total of 38 players (15.3 ± 0.49 years, 59.7 ± 7.14 kg, 152.1 ± 53.3 cm) of a Greek football club participated in a progressive 4-week strengthening program, performing both the NH and CA exercises twice a week during the team's pre-season period. Isometric hamstring and eccentric hip adduction strength were assessed using a hand-held dynamometer, while jump and sprint performance were also tested. Perceived exertion was recorded throughout the intervention.</div></div><div><h3>Results</h3><div>Isometric hamstring strength increased by 11 % (p &lt; 0.000) and eccentric adduction strength increased by 17 % (p &lt; 0.000). There was a decrease of 5–7% (p = 0.000 to p = 0.034) in jump performance, and an improvement of 2–3% (p = 0.009 to p = 0.253) in sprint performance. There was no statistically significant difference for perceived exertion between the two exercises (p = 0.084–1.000).</div></div><div><h3>Conclusion</h3><div>A 4-week progressive exercise program with the Nordic Hamstring and Copenhagen Adduction exercises combined resulted in statistically significant improvements in both isometric hamstring and eccentric adduction strength, but it did not lead to significant results in jump and sprint performance.</div></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 1","pages":"Article 100524"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management outcome of knee septic arthritis in neonates and infants:A systematic review","authors":"Hilmi Muhammad ,&nbsp;Rahadyan Magetsari ,&nbsp;Alfin Ihza Trimahendra ,&nbsp;Paramita Ayu Saraswati","doi":"10.1016/j.jorep.2024.100518","DOIUrl":"10.1016/j.jorep.2024.100518","url":null,"abstract":"<div><h3>Introduction</h3><div>Septic arthritis (SA) is considered an orthopedic emergency especially when occurring in infants yet the gold standard for its management is yet to be determined with only a scanty amount of research carried out the detailed outcomes information from different types of treatment used. This review identifies the detailed outcomes of infants with knee SA managed by various types of therapy.</div></div><div><h3>Material and methods</h3><div>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used as guidelines in constructing this review. The study protocol was registered into the International Prospective Register of Systematic Reviews database prior to this review commencement (CRD42022379017). In October 2022, a thorough search was first conducted on PubMed, Cochrane Library, Scopus, and Web of Science. We focused on including findings with the population of interest being infants with knee SA who underwent various types of therapy consisting of surgical intervention and antibiotic administration with detailed outcomes.</div></div><div><h3>Results</h3><div>A total of 14 articles were included, extracting detailed outcomes of infantile knee SA cases managed by different treatment choices. Only 3 articles reported the full information regarding the patient's outcomes where the patient's quality of life was the most reported information followed by range of motion and laboratory evaluation in 8 studies, and radiographic evaluation in 7 studies.</div></div><div><h3>Conclusion</h3><div>Detailed patient outcomes and specific data regarding the patient's demographics including risk factors are needed to construct the guidelines for infantile knee SA for more uniform management consisting of surgical intervention and antibiotic administration with its duration.</div></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100518"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of interobserver reliability and intraobserver repeatability of letournel and judet classification for acetabular fractures","authors":"Deependra Yadav (Dr) ,&nbsp;Bibek Banskota (Dr) ,&nbsp;Rajendra Aryal (Dr) ,&nbsp;Nitesh raj Pandey (Dr) ,&nbsp;Ansul raj Bhandari (Dr) ,&nbsp;Rajan Bhusal ,&nbsp;Ashok Kumar Banskota (Dr)","doi":"10.1016/j.jorep.2024.100519","DOIUrl":"10.1016/j.jorep.2024.100519","url":null,"abstract":"<div><h3>Background</h3><div>Acetabular fractures account for 1–2% of all fractures and pose significant challenges for orthopedic surgeons due to complex anatomy and risks of long-term functional impairment. The Letournel and Judet (L-J) classification system, while popular for its simplicity and association with surgical outcomes, raises concerns about interobserver reliability and intraobserver repeatability across different populations.</div></div><div><h3>Objective</h3><div>To assess the interobserver reliability and intraobserver repeatability of the L-J classification for acetabular fractures and evaluate the impact of CT scans on classification reliability.</div></div><div><h3>Methods</h3><div>This prospective observational study was conducted at B &amp; B Hospital, Gwarko, Lalitpur, Nepal, over one year. A total of 45 skeletally mature patients with confirmed acetabular fractures were recruited. Six experienced pelvic surgeons were divided into three groups and independently classified each fracture using the L-J system based on plain radiographs, Judet views, and CT scans.</div></div><div><h3>Results</h3><div>The mean age of participants was 36.75 years, with 86 % male representation. Fracture side distribution showed 46 % on the left and 54 % on the right. Interobserver reliability, assessed using Cohen's kappa coefficient, showed substantial agreement (k = 0.77) for most fracture types. Intraobserver repeatability also demonstrated substantial consistency among individual assessors over time. The evaluation of CT scans revealed insights into the reliability of the L-J classification system.</div></div><div><h3>Conclusion</h3><div>This study enhances the understanding of the L-J classification's reliability for acetabular fractures, providing crucial information for its effective implementation in clinical practice.</div></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100519"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilient orthopaedic generation: The orthopaedic registrars who started training in 2020","authors":"Collen Sandile Nkosi","doi":"10.1016/j.jorep.2024.100517","DOIUrl":"10.1016/j.jorep.2024.100517","url":null,"abstract":"","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100517"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the research productivity of orthopaedic surgery residents","authors":"Alexis M. Driscoll ,&nbsp;Christopher J. Hawryluk ,&nbsp;Rebecca Klausner ,&nbsp;Isabel H. Herzog ,&nbsp;Claudia Siniakowicz ,&nbsp;Kathleen S. Beebe","doi":"10.1016/j.jorep.2024.100520","DOIUrl":"10.1016/j.jorep.2024.100520","url":null,"abstract":"<div><h3>Introduction</h3><div>The factors that contribute to resident academic productivity are unknown. The primary goal of this study is to determine if factors such as program reputation, residency geographic region, and resident gender are associated with the research productivity of orthopaedic surgery residents.</div></div><div><h3>Methods</h3><div>Top Doximity-ranking residency programs in 2021–2022 were selected for analysis. Residents were identified using program websites. Resident publications on Scopus and PubMed from July 1 of resident PGY1 year to December 2021 were collected. Demographic data including resident gender, training year, and medical school affiliation were collected. Program geographic location was collected and stratified by state. The number and type of publications, authorship position, and journal impact factor measured research productivity. Chi-square and Mann-Whitney U-tests were used to perform statistical analyses.</div></div><div><h3>Results</h3><div>Among 16 of the top 25 Doximity-ranked programs studied, 560 residents were identified, 423 (75.5%) male, and 137 (24.5%) female. The median number of overall publications was 3 per resident. When stratified by class, the median number of publications per resident was 1, 2, 3, 5, and 7 for the PGY1 through PGY5 classes, respectively. Male and female residents had a median of 3 total articles, but there was a significant difference between the distribution (p = 0.004). There was a significant difference in the percentage of times published in a top orthopaedic surgery journal between male and female authors (p = 0.027). There was no significant difference in research productivity by region, except for the Northeast, where residents produced significantly more publications (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Factors associated with increased research productivity during residency training include male gender, medical school ranking, and residency program in the Northeast region. Although it might be improving, gender differences still exist within the field of orthopaedics.</div></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 1","pages":"Article 100520"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronal plane alignment of knee (CPAK) classification in Indians undergoing total knee arthroplasty: Are there racial differences in phenotype distribution?","authors":"Akshay Ks ,&nbsp;Pathik Shah ,&nbsp;Rahul Ragate ,&nbsp;Aashiket Sable ,&nbsp;Vaibhav Bagaria","doi":"10.1016/j.jorep.2024.100521","DOIUrl":"10.1016/j.jorep.2024.100521","url":null,"abstract":"<div><h3>Introduction</h3><div>Optimizing alignment &amp; balance strategies during Total Knee Arthroplasty (TKA) requires a comprehensive understanding of lower limb constitutional alignment. The coronal plane alignment of the knee (CPAK) classification system has become a widely adopted tool. This study aims to categorize arthritic knees in the Indian population using the CPAK categorization system and to investigate potential racial variations in the distribution of CPAK phenotypes.</div></div><div><h3>Materials and methods</h3><div>A retrospective observational study was done, including 378 patients (261 females, 117 males) with 500 arthritic knees. These patients underwent radiological evaluation using a standardized digital long-leg scannogram and various angles, which include the medial proximal tibial angle (MPTA), mechanical lateral distal femoral angle (mLDFA), and mHKA (mechanical hip-knee-ankle angle) had been measured. Both mHKA &amp; arithmetic hip-knee-ankle angle (aHKA), as well as JLO, have been assessed. As per these measurements, the arthritic knees were classified into the nine previously described CPAK types.</div></div><div><h3>Results</h3><div>Among the 500 arthritic knees, the majority were classified as Type I (220 knees, 44 %) and Type IV (111 knees, 22.2 %). The mean aHKA was −4.70° ± 6.31°, and the mean JLO was 175.89° ± 5.31°, indicating a predominance of constitutional varus alignment having an apex-distal or apex-neutral JLO. When mHKA versus JLO was plotted according to the CPAK classification, similar findings were observed, with Type I (255 knees, 55 %) and Type IV (129 knees, 25.8 %) being the most prevalent.</div></div><div><h3>Conclusion</h3><div>Significant variations were observed in the CPAK distribution among Indian patients undergoing TKA, predominating varus alignment and apex-distal or neutral joint line orientations (Types I and IV). This differs from the original CPAK study, where Type II was the most common phenotype. These outcomes give valuable insights into the patterns of arthritic knee alignment in the Indian population undergoing TKA, which may influence surgical planning and outcomes.</div></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 1","pages":"Article 100521"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}