26dkou073 10.3205/26dkou073 urn:nbn:de:0183-26dkou0734 Meeting Abstract Pott Pott Hendrik H

Carl-von-Ossietzky Universität Oldenburg, Division of Orthopaedics at Campus Pius-Hospital, Oldenburg, Deutschland

author Savov Savov Peter P

Carl-von-Ossietzky Universität Oldenburg, Division of Orthopaedics at Campus Pius-Hospital, Oldenburg, Deutschland

author Stauß Stauß Ricarda R

Carl-von-Ossietzky Universität Oldenburg, Division of Orthopaedics at Campus Pius-Hospital, Oldenburg, Deutschland

author Chen Chen Darren D

Sydney Knee Specialists, Sydney, Australien

author MacDessi MacDessi Samuel S

Sydney Knee Specialists, Sydney, Australien

author Ettinger Ettinger Max M

Carl-von-Ossietzky Universität Oldenburg, Division of Orthopaedics at Campus Pius-Hospital, Oldenburg, Deutschland

author German Medical Science GMS Publishing House

Düsseldorf

610 20261020 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0659 073 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026) Abstracts | Kinderorthopädie Berlin 20261020 20261023 DKOU26_Abs_2356 TextObjectives and questions: The Coronal Plane Alignment of the Knee classification (CPAK) describes nine knee phenotypes by defining arithmetic hip-knee-ankle angle (aHKA) and joint line obliquity (JLO). In this study, the CPAK classification was used to analyse the development of lower limb alignment in children and adolescents, providing reference values and allowing insights into the morphogenesis of the knee joint during skeletal maturation.Material and methods: Angular measurements of 655 knees taken on CT scans of 333 children aged between 4 and 18 years from a publicly available radiologic database were retrospectively analysed, applying the CPAK classification by calculating the arithmetic hip-knee-ankle angle (aHKA) and joint line obliquity (JLO).Results: The aHKA averaged 3.4° ± 3.1°. Joint line obliquity became more pronounced with age, decreasing from an average of 176.8° ± 4.2° at the age of 4 to 172.8° ± 3.1° at the age of 18. The most common CPAK type under the age of 18 was CPAK III (58.2%), the second most common type was CPAK II (24.7%) and the third most prevalent type was CPAK IV (10.1%).Discussion and conclusions: This is the first study analysing lower limb alignment in children and adolescents using the CPAK classification. By simultaneously developing a distal femoral valgus and a counteracting proximal tibial varus morphology, overall constitutional alignment as represented by the aHKA remains almost constant between the age of 4 and 18. Conversely, joint line obliquity changes significantly with age towards an apex distal phenotype. We provide a comprehensive explanation for the physiological development of lower limb alignment during skeletal growth. 0 0 0 0