ReviewArthroplasty (London, England)2025
A systematic review of geographic differences in knee phenotypes based on the coronal plane alignment of the knee (CPAK) classification.
Review in Arthroplasty (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- The coronal plane alignment of the knee classification cannot ignore the joint line convergence angle.BMC musculoskeletal disorders · 2026Article
- Alignment and/or ligament balancing? Towards truly personalized total knee arthroplasty-A narrative review.Journal of experimental orthopaedics · 2026Review
- Patient Perception of Lower-Limb Straightness at One Week After Unrestricted Kinematically Aligned Total Knee Arthroplasty: Exploring the Concept of "Inherent Straightness".Journal of personalized medicine · 2026Article
- Coronal plane alignment of the knee phenotypes and ankle joint coronal plane alignment patterns in Egyptian population.World journal of orthopedics · 2026Article
- Anatomical Risk Factors for Lower Extremity Musculoskeletal Disorders and Proposed Prevention Strategies.Physical therapy research · 2026Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe extent of geographic variation in knee phenotypes remains insufficiently documented. This systematic review intends to elucidate the regional disparities in the distribution of Coronal Plane Alignment of the Knee (CPAK) types across different geographic areas.
methodsA systematic review of the literature was conducted in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies reporting the distribution of knee phenotypes, as classified by the CPAK system, in both healthy and arthritic populations, were included in the analysis. Based on the methods in the literature, the Hoy Risk of Bias Tool was used to assess the methodological quality of the included studies. To compare geographical differences in CPAK types among patients with arthritis, as well as healthy people.
resultsA total of 29 studies (28 retrospective and 1 prospective) were included in this review, encompassing 27,660 knees in 22,342 subjects. The methodological quality of the included studies was assessed using the Hoy Risk of Bias Tool, and the quality was good. Among the healthy knees (n = 4,082), CPAK type II was predominant in Europe (41.7%) and Asia (36.7%). In contrast, among arthritic knees (n = 21,632), CPAK type I was most common in Asia (51.3%), North America (32.8%), and Europe (32.8%), while CPAK type II was prevalent in Australia (29.3%) and Africa (25.5%). Notably, the proportions of CPAK type I (P < 0.001) and II (P = 0.002) knees varied significantly across different geographic regions among arthritic knees, while no significant differences were observed among healthy knees (P = 0.48, P = 0.305).
conclusionSignificant variations in CPAK distributions among arthritic knees were observed across countries, while no significant differences were observed among healthy knees. Surgeons in different regions need to make individual surgical plans according to the CPAK types of patients. Video Abstract.
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