Abstract：
BACKGROUND: Disagreement exists on the optimal coronal alignment target for lateral unicompartmental knee arthroplasty (UKA). An improved understanding of the distribution of coronal alignment and joint line orientation in lateral osteoarthritis (OA) might prove beneficial. The aim of this study was to evaluate the pre- and postoperative Coronal Plane Alignment of the Knee (CPAK) distribution following lateral UKA and to evaluate the association between phenotypic variation and patient-reported outcome measures (PROMs).
METHODS: A surgeon\'s registry was retrospectively reviewed between 2012 and 2022 to identify patients who received primary lateral UKA for advanced, lateral compartment OA. Radiographic measurements were performed, and CPAK phenotypes were determined. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Kujala, and patient satisfaction were analyzed at one-year and two-year follow-up.
RESULTS: A total of 305 knees were included. Preoperatively, seven phenotypes were observed and CPAK3 (54.1%) was most commonly observed. Postoperatively, all nine phenotypes were observed and CPAK6 (32.8%) was predominant. Preoperatively, 23.6% did not have a prearthritic valgus alignment. No significant differences in PROMs were found between individual phenotypes or between preserved and altered phenotypes.
CONCLUSIONS: Coronal alignment and joint line orientation were highly variable within a lateral compartment OA cohort. However, no association was demonstrated between superior postoperative PROMs and phenotype variation or phenotype preservation, which might suggest that there is not one universal optimal alignment target. Interestingly, 23.6% of knees with lateral compartment OA did not have a prearthritic valgus alignment, which may have been affected by joint line orientation.
METHODS: A surgeon\'s registry was retrospectively reviewed between 2012 and 2022 to identify patients who received primary lateral UKA for advanced, lateral compartment OA. Radiographic measurements were performed, and CPAK phenotypes were determined. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Kujala, and patient satisfaction were analyzed at one-year and two-year follow-up.
RESULTS: A total of 305 knees were included. Preoperatively, seven phenotypes were observed and CPAK3 (54.1%) was most commonly observed. Postoperatively, all nine phenotypes were observed and CPAK6 (32.8%) was predominant. Preoperatively, 23.6% did not have a prearthritic valgus alignment. No significant differences in PROMs were found between individual phenotypes or between preserved and altered phenotypes.
CONCLUSIONS: Coronal alignment and joint line orientation were highly variable within a lateral compartment OA cohort. However, no association was demonstrated between superior postoperative PROMs and phenotype variation or phenotype preservation, which might suggest that there is not one universal optimal alignment target. Interestingly, 23.6% of knees with lateral compartment OA did not have a prearthritic valgus alignment, which may have been affected by joint line orientation.
摘要：
背景：对于外侧单室膝关节置换术（UKA）的最佳冠状排列目标存在分歧。对外侧骨关节炎（OA）的冠状排列和关节线方向的分布有更深入的了解可能是有益的。这项研究的目的是评估外侧UKA术后膝关节的冠状平面对齐（CPAK）分布，并评估表型变异与患者报告的结局指标（PROMs）之间的关联。
方法：2012年至2022年期间，对外科医生的注册进行了回顾性审查，以确定接受原发性外侧UKA晚期的患者，横向隔间OA。进行射线照相测量，并确定了CPAK表型。膝关节损伤和骨关节炎结果评分（KOOS），Kujala,在1年和2年随访时分析患者满意度.
结果：共纳入305个膝关节。术前,观察到7种表型，最常见的是CPAK3（54.1％）。术后,观察到所有9种表型,以CPAK6(32.8%)为主.术前,23.6%的患者没有关节炎前外翻对齐。在各个表型之间或保存的和改变的表型之间没有发现PROM的显着差异。
结论：在侧室OA队列中，冠状排列和关节线方向是高度可变的。然而,术后优势PROM与表型变异或表型保留之间无关联，这可能表明没有一个通用的最佳对准目标。有趣的是,23.6％的外侧间室OA的膝盖没有关节炎前外翻对齐，这可能受到关节线方向的影响。
方法：2012年至2022年期间，对外科医生的注册进行了回顾性审查，以确定接受原发性外侧UKA晚期的患者，横向隔间OA。进行射线照相测量，并确定了CPAK表型。膝关节损伤和骨关节炎结果评分（KOOS），Kujala,在1年和2年随访时分析患者满意度.
结果：共纳入305个膝关节。术前,观察到7种表型，最常见的是CPAK3（54.1％）。术后,观察到所有9种表型,以CPAK6(32.8%)为主.术前,23.6%的患者没有关节炎前外翻对齐。在各个表型之间或保存的和改变的表型之间没有发现PROM的显着差异。
结论：在侧室OA队列中，冠状排列和关节线方向是高度可变的。然而,术后优势PROM与表型变异或表型保留之间无关联，这可能表明没有一个通用的最佳对准目标。有趣的是,23.6％的外侧间室OA的膝盖没有关节炎前外翻对齐，这可能受到关节线方向的影响。
