Evidence map›Paper›PMID 41031620›Full record

ReviewEFORT open reviews2025

Biplanar radiographic analysis of knee alignment: a stepwise approach for phenotype classification and knee arthroplasty planning.

Shuhei Hiyama, Reuben P Rao, Tsuneari Takahashi, Jeya Palan, Hemant Pandit

Abstract readReview
In one paragraph

Review in EFORT open reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Shuhei HiyamaLeeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK.ORCID https://orcid.org/0000-0003-2728-2338
Reuben P RaoSarawak General Hospital, Kuching, Sarawak, Malaysia.
Tsuneari TakahashiDepartment of Orthopedics, Jichi Medical University, Shimotsuke, Japan.
Jeya PalanLeeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK.ORCID https://orcid.org/0000-0002-9859-274X
Hemant PanditLeeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This review presents a standardized, stepwise method for biplanar radiographic analysis of knee alignment, integrating both coronal and sagittal measurements for use in arthritic and non-arthritic knees. It critically compares leading classification systems, including the coronal plane alignment of the knee (CPAK) and the functional knee phenotype classifications. While CPAK provides a simplified 2D coronal model, the functional phenotype system offers a more granular, 3D approach that includes segmental deformities and has recently been expanded to incorporate laxity parameters. Sagittal plane parameters - including posterior tibial slope and femoral component flexion/extension - are essential for comprehensive alignment assessment. These factors influence implant positioning, knee kinematics, and postoperative function. The review outlines preferred measurement techniques, highlighting the value of long-leg weight-bearing radiographs and discussing the limitations and variability of 2D versus 3D imaging approaches. Incorporating both alignment and soft tissue behavior provides a more individualized approach to total knee arthroplasty planning and may lead to improved outcomes by better replicating native knee biomechanics.

Indexed as

arthroplastykneeknee jointlower extremityosteoarthritispostural balancereplacement

Identifiers

PMID41031620
PMCPMC12494059

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.