{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T23:17:27Z","timestamp":1776381447806,"version":"3.51.2"},"reference-count":37,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T00:00:00Z","timestamp":1697587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: There is an ongoing discussion about the best alignment targets in total knee arthroplasty (TKA). Mechanical alignment has been the standard in TKA for years. Alongside the development of various classification systems to describe the native alignment of the knee (knee phenotype), kinematic alignment restoring the individual phenotype of the knee has been advocated more recently. Alignment in TKA becomes even more challenging in knees with preoperative deformities such as valgus osteoarthritis. Materials and Methods: The study retrospectively evaluated 158 knees in 135 patients who underwent TKA with a mechanical alignment target for valgus osteoarthritis. Pre- and postoperative hip knee angle, lateral distal femur angle, and medial proximal tibial angle\/tibial plate angle (pre-\/postoperative) were measured on standing hip-to-ankle radiographs. Knees were grouped according to the coronal plane alignment of the knee (CPAK) classification. Preoperative and postoperative range of motion and patient-related outcome measures (WOMAC, UCLA, SF-12, pain) were assessed. Results: There was no difference in outcome for mechanically aligned TKA between the different CPAK phenotypes, suggesting that mechanical alignment is an appropriate target for the different phenotypes analyzed in the study. Remaining valgus alignment was associated with decreased postoperative UCLA scores and decreased improvement in SF-12 scores (p = 0.011\/p = 0.028). Within CPAK III, mechanical aligned TKA showed better postoperative UCLA Scores than TKA with valgus alignment (p = 0.015). The individual knee phenotype in patients with valgus osteoarthritis did not influence the outcome of mechanical aligned TKA operated with standardized soft-tissue release.<\/jats:p>","DOI":"10.3390\/medicina59101852","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T09:55:06Z","timestamp":1697622906000},"page":"1852","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Individual Phenotype Does Not Impact the Outcome of Mechanical Aligned Total Knee Arthroplasties for Valgus Osteoarthritis"],"prefix":"10.3390","volume":"59","author":[{"given":"Laura E.","family":"Streck","sequence":"first","affiliation":[{"name":"Adult Reconstruction and Joint Replacement Department, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9319-2416","authenticated-orcid":false,"given":"Martin","family":"Faschingbauer","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7811-7493","authenticated-orcid":false,"given":"Marco","family":"Brenneis","sequence":"additional","affiliation":[{"name":"The Complex Joint Reconstruction Centre at Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA"},{"name":"Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cosima S.","family":"Boettner","sequence":"additional","affiliation":[{"name":"Adult Reconstruction and Joint Replacement Department, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kilian","family":"List","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Wuerzburg, Brettreichstrasse 11, 97074 Wuerzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4981-8607","authenticated-orcid":false,"given":"Maximilian F.","family":"Kasparek","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Evangelisches Krankenhaus, Hans-Sachs Gasse 10-12, 1180 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7906-9486","authenticated-orcid":false,"given":"Friedrich","family":"Boettner","sequence":"additional","affiliation":[{"name":"Adult Reconstruction and Joint Replacement Department, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/00003086-200111000-00029","article-title":"Polyethylene contact stresses, articular congruity, and knee alignment","volume":"392","author":"Chen","year":"2001","journal-title":"Clin. 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