Peter Bollars, Hans Feyen, Dinesh Nathwani, Ali Albelooshi, Max Ettinger, Ronny De Corte, Martijn G. M. Schotanus
{"title":"一项随机对照试验：常规或机器人辅助全膝关节置换术后，术后cpap分级的变化对患者报告的结果测量没有显著影响。","authors":"Peter Bollars, Hans Feyen, Dinesh Nathwani, Ali Albelooshi, Max Ettinger, Ronny De Corte, Martijn G. M. Schotanus","doi":"10.1002/ksa.12740","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>The purpose of this study was to investigate the impact of pre- and postoperative changes in Coronal Plane Alignment of the Knee (CPAK) classification on patient-reported outcome measures (PROMs) and to determine the rate of CPAK classification change in patients undergoing either conventionally aligned total knee arthroplasty (CTKA) or imageless robotic-assisted total knee arthroplasty (RATKA). We hypothesised that PROM improvements would be comparable regardless of whether postoperative CPAK classification was preserved (“In-the-box”) or altered (“Out-of-the-box”) in both surgical techniques.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this prospective randomised controlled trial, 180 patients were assigned to either CTKA or RATKA. CPAK classification was assessed pre- and postoperatively. PROMs were collected at baseline, 3, and 12 months postoperatively, including the Knee Society Score, Oxford Knee Score, visual analog scale (VAS) for daytime and night time pain, EuroQol-5D (index and VAS), and patient satisfaction.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Baseline characteristics were similar between groups. Native CPAK classification was preserved in 31% of CTKA and 41% of RATKA patients. Postoperatively, CPAK II was most common (40% CTKA and 49% RATKA), followed by CPAK V. Both groups showed significant improvements in all PROMs at 3- and 12-months, regardless of CPAK classification change, and operative technique.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Short-term functional outcomes following TKA were not significantly influenced by In-the-box or Out-of-the box CPAK classification. Both CTKA and RATKA yielded comparable PROM improvements. Although altered CPAK often required greater soft-tissue release, especially in CTKA, this did not affect outcomes, suggesting alignment strategy should prioritise individual anatomy and soft-tissue balance over strict CPAK matching.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level I.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 9","pages":"3333-3340"},"PeriodicalIF":5.0000,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Postoperative changes in CPAK-classification do not significantly influence patient-reported outcome measures following conventional or robotic-assisted total knee arthroplasty: A randomised controlled trial\",\"authors\":\"Peter Bollars, Hans Feyen, Dinesh Nathwani, Ali Albelooshi, Max Ettinger, Ronny De Corte, Martijn G. M. Schotanus\",\"doi\":\"10.1002/ksa.12740\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>The purpose of this study was to investigate the impact of pre- and postoperative changes in Coronal Plane Alignment of the Knee (CPAK) classification on patient-reported outcome measures (PROMs) and to determine the rate of CPAK classification change in patients undergoing either conventionally aligned total knee arthroplasty (CTKA) or imageless robotic-assisted total knee arthroplasty (RATKA). We hypothesised that PROM improvements would be comparable regardless of whether postoperative CPAK classification was preserved (“In-the-box”) or altered (“Out-of-the-box”) in both surgical techniques.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>In this prospective randomised controlled trial, 180 patients were assigned to either CTKA or RATKA. CPAK classification was assessed pre- and postoperatively. PROMs were collected at baseline, 3, and 12 months postoperatively, including the Knee Society Score, Oxford Knee Score, visual analog scale (VAS) for daytime and night time pain, EuroQol-5D (index and VAS), and patient satisfaction.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Baseline characteristics were similar between groups. Native CPAK classification was preserved in 31% of CTKA and 41% of RATKA patients. Postoperatively, CPAK II was most common (40% CTKA and 49% RATKA), followed by CPAK V. Both groups showed significant improvements in all PROMs at 3- and 12-months, regardless of CPAK classification change, and operative technique.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Short-term functional outcomes following TKA were not significantly influenced by In-the-box or Out-of-the box CPAK classification. Both CTKA and RATKA yielded comparable PROM improvements. 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Postoperative changes in CPAK-classification do not significantly influence patient-reported outcome measures following conventional or robotic-assisted total knee arthroplasty: A randomised controlled trial
Purpose
The purpose of this study was to investigate the impact of pre- and postoperative changes in Coronal Plane Alignment of the Knee (CPAK) classification on patient-reported outcome measures (PROMs) and to determine the rate of CPAK classification change in patients undergoing either conventionally aligned total knee arthroplasty (CTKA) or imageless robotic-assisted total knee arthroplasty (RATKA). We hypothesised that PROM improvements would be comparable regardless of whether postoperative CPAK classification was preserved (“In-the-box”) or altered (“Out-of-the-box”) in both surgical techniques.
Methods
In this prospective randomised controlled trial, 180 patients were assigned to either CTKA or RATKA. CPAK classification was assessed pre- and postoperatively. PROMs were collected at baseline, 3, and 12 months postoperatively, including the Knee Society Score, Oxford Knee Score, visual analog scale (VAS) for daytime and night time pain, EuroQol-5D (index and VAS), and patient satisfaction.
Results
Baseline characteristics were similar between groups. Native CPAK classification was preserved in 31% of CTKA and 41% of RATKA patients. Postoperatively, CPAK II was most common (40% CTKA and 49% RATKA), followed by CPAK V. Both groups showed significant improvements in all PROMs at 3- and 12-months, regardless of CPAK classification change, and operative technique.
Conclusions
Short-term functional outcomes following TKA were not significantly influenced by In-the-box or Out-of-the box CPAK classification. Both CTKA and RATKA yielded comparable PROM improvements. Although altered CPAK often required greater soft-tissue release, especially in CTKA, this did not affect outcomes, suggesting alignment strategy should prioritise individual anatomy and soft-tissue balance over strict CPAK matching.
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).
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