ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022
The contralateral limb is no reliable reference to restore coronal alignment in TKA.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- CPAK classification shows limited side-to-side agreement and limited reliability as a standalone surrogate for constitutional alignment in rheumatoid arthritis knees.Journal of experimental orthopaedics · 2026Article
- The Coronal Plane Alignment of the Knee Classification May be Unreliable With Advanced Knee Arthritis.Arthroplasty today · 2026Article
- Article
- Sex-specific patterns and limited bilateral symmetry in coronal knee alignment: Insights from the modified coronal plane alignment of the knee classification.Osteoarthritis and cartilage open · 2026Article
- Low bilateral consistency restricts the utility of the contralateral CPAK as a reliable reference for planning coronal alignment in total knee arthroplasty.BMC musculoskeletal disorders · 2025Article
- The influence of CPAK classification on the pivot motion between kinematic and mechanical alignment total knee arthroplasty.Journal of orthopaedics · 2025Article
- Navigated versus conventionally instrumented total knee arthroplasty techniques: No difference in functional alignment or balance.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Novel Surgical Technique for Total Knee Arthroplasty Integrating Kinematic Alignment and Real-Time Elongation of the Ligaments Using the NextAR System.Journal of personalized medicine · 2024Article
- Evaluation of the effect of vascularized fibula graft harvesting on coronal plane alignment and functional outcomes of the lower limb.Scientific reports · 2024Article
- Joint line and knee osteotomy.EFORT open reviews · 2024Review
- Only 26% of Native Knees Show an Identical Coronal Functional Knee Phenotype in the Contralateral Knee.Journal of personalized medicine · 2024Article
- A Radiographic Analysis of Coronal Morphological Parameters of Lower Limbs in Chinese Non-knee Osteoarthritis Populations.Orthopaedic surgery · 2024Article
- Femoral neck shortening as a sequela of internal fixation for femoral neck fractures and its effect on the coronal alignment of the limb: a pilot study.Archives of orthopaedic and trauma surgery · 2024Article
- Long leg radiographs underestimate the degree of constitutional varus limb alignment and joint line obliquity in comparison with computed tomography: a radiographic study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- The pre-diseased coronal alignment can be predicted from conventional radiographs taken of the varus arthritic knee.Archives of orthopaedic and trauma surgery · 2023Article
- Osteoarthritic and non-osteoarthritic patients show comparable coronal knee joint line orientations in a cross-sectional study based on 3D reconstructed CT images.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Ethnical Differences in Knee Phenotypes Indicate the Need for a More Individualized Approach in Knee Arthroplasty: A Comparison of 80 Asian Knees with 308 Caucasian Knees.Journal of personalized medicine · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeImplementation of morphometric reference data from the contralateral, unaffected lower limb is suggested when reconstructing the coronal plane alignment in TKA. Limited information, however, is available which confirms this left-to-right symmetry in coronal alignment based upon radiographs. The purpose of the study was, therefore, (1) to verify if a left-to-right symmetry is present and (2) to assess whether the contralateral lower limb would be a reliable reference for reconstructing the frontal plane alignment.
methodsFull-leg standing radiographs of 250 volunteers (male, 125; female,125) were reviewed for three alignment parameters (Hip-Knee-Ankle angle (HKA), Femoral Mechanical Angle (FMA) and Tibial Mechanical Angle (TMA)). Evaluation of assumed left-to-right symmetry was performed according to two coronal alignment classifications (HKA subdivisions (HKA) and limb, femoral and tibial phenotypes (HKA, FMA and TMA)). Inter- and within-subject variability was calculated, along with correlations coefficients (r) and coefficients of determination (r
resultsSymmetrical distribution in coronal alignment was found in 79% (HKA subdivision) and 59% (limb phenotype) of the cohort. Gender differences were present for the most common symmetric limb phenotypes (VAR
conclusionNo strict left-to-right symmetry was observed in coronal alignment measurements. There is insufficient left-to-right agreement to consider the concept of the contralateral unaffected limb as an idealized reference for frontal plane alignment reconstruction based upon full-leg standing radiographs. LEVEL OF EVIDENCE: I.
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