This study proposes a standardized vocabulary for coronal knee alignment in TKA. Using 11,991 OA knees on 3D CT, it defines neutral, normal, deviant, and aberrant alignment by standard deviations from a non-OA reference population. It answers a basic question of the personalized alignment debate: what counts as normal versus pathological?
The personalized alignment debate stalled on a basic problem: surgeons used words like normal, abnormal, and pathological without agreeing on what they meant. This paper fixes that by anchoring each term to standard deviations from a healthy non-OA population.
The mental model to carry into the OR: restore alignment that is neutral or normal, adjust deviant alignment toward the safe zone, and do not reproduce aberrant alignment. Roughly aberrant means HKA beyond 9° varus or 8° valgus.
The weak FMA–TMA correlation (r=0.11) is the conceptual core. The same HKA can arise from very different femur and tibia geometry, which is exactly why phenotyping all three angles beats targeting global HKA alone.
Weigh the evidence carefully. This is Level III cross-sectional CT data from mainly Caucasian PSI-TKA patients, with no outcome data linking these targets to function or survivorship. Severe deformities are likely underrepresented, so the framework defines anatomy, not yet results.
This study proposes a standardized vocabulary for coronal knee alignment in TKA. Using 11,991 OA knees on 3D CT, it defines neutral, normal, deviant, and aberrant alignment by standard deviations from a non-OA reference population. It answers a basic question of the personalized alignment debate: what counts as normal versus pathological?
The personalized alignment debate stalled on a basic problem: surgeons used words like normal, abnormal, and pathological without agreeing on what they meant. This paper fixes that by anchoring each term to standard deviations from a healthy non-OA population.
The mental model to carry into the OR: restore alignment that is neutral or normal, adjust deviant alignment toward the safe zone, and do not reproduce aberrant alignment. Roughly aberrant means HKA beyond 9° varus or 8° valgus.
The weak FMA–TMA correlation (r=0.11) is the conceptual core. The same HKA can arise from very different femur and tibia geometry, which is exactly why phenotyping all three angles beats targeting global HKA alone.
Weigh the evidence carefully. This is Level III cross-sectional CT data from mainly Caucasian PSI-TKA patients, with no outcome data linking these targets to function or survivorship. Severe deformities are likely underrepresented, so the framework defines anatomy, not yet results.