Khalifa AA, Moustafa M, Lemma S, Fayez M, Abdelaal AM, Fadle AA. Coronal plane alignment of the knee phenotypes and ankle joint coronal plane alignment patterns in Egyptian population. World J Orthop 2026; 17(1): 111824 [DOI: 10.5312/wjo.v17.i1.111824]
Corresponding Author of This Article
Ahmed A Khalifa, MD, Assistant Professor, FRCS, Department of Orthopaedics, Qena Faculty of Medicine and University Hospital, South Valley University, Kilo 6 Qena-Safaga Highway, Qena 83523, Egypt. ahmed_adel0391@med.svu.edu.eg
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jan 18, 2026; 17(1): 111824 Published online Jan 18, 2026. doi: 10.5312/wjo.v17.i1.111824
Coronal plane alignment of the knee phenotypes and ankle joint coronal plane alignment patterns in Egyptian population
Ahmed A Khalifa, Mohamed Moustafa, Shikuria Lemma, Mostafa Fayez, Ahmed M Abdelaal, Amr A Fadle
Ahmed A Khalifa, Department of Orthopaedics, Qena Faculty of Medicine and University Hospital, South Valley University, Qena 83523, Egypt
Mohamed Moustafa, Mostafa Fayez, Ahmed M Abdelaal, Amr A Fadle, Department of Orthopedic Surgery and Traumatology, Assiut University Hospital, Assiut 71515, Egypt
Shikuria Lemma, Department of Orthopaedics, Black Lion Specialized Hospital, Addis Ababa 1165, Ethiopia
Author contributions: Khalifa AA carried out the study conception and design; Khalifa AA, Fayez M, Lemma S, and Moustafa M performed data acquisition, assessment, literature search, and prepared the images and tables; Fadle AA and Lemma S performed the measurements; Khalifa AA carried out the statistical analysis; Khalifa AA, Abdelaal MA, and Fadle AA drafted the manuscript; Abdelaal AM and Khalifa AA did the critical revision. All authors read, discussed, and approved the final manuscript.
Institutional review board statement: This study was approved by Institutional Review Board of Faculty of Medicine in Assiut University, No. 04-2024-300470.
Informed consent statement: This study was conducted retrospectively using anonymized radiographic data. No patient-identifiable information was collected or reported, and no direct patient contact occurred. Therefore, the requirement for informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All the data are included within the manuscript; however, the raw data could be provided and shared upon a written request sent to the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ahmed A Khalifa, MD, Assistant Professor, FRCS, Department of Orthopaedics, Qena Faculty of Medicine and University Hospital, South Valley University, Kilo 6 Qena-Safaga Highway, Qena 83523, Egypt. ahmed_adel0391@med.svu.edu.eg
Received: July 10, 2025 Revised: August 24, 2025 Accepted: November 13, 2025 Published online: January 18, 2026 Processing time: 183 Days and 18.1 Hours
Core Tip
Core Tip: We consider the current study one of the few studies that have investigated the coronal plane alignment of the knee in a North African population; furthermore, adding subtypes based on the ankle joint line orientation was not previously proposed. After evaluating 527 patients (1054 knees), we found that most knees demonstrated varus alignment (76.4%) and an apex distal joint line obliquity (55.3%). Understanding the coronal plane alignment of the knee classification in our knee osteoarthritis population will help surgeons who are willing to adopt a more personalized total knee arthroplasty alignment approach; furthermore, the added subtypes based on the ankle joint line orientation should be considered during preoperative planning.
