scholarly journals Kinematic alignment in total knee arthroplasty: Does it really matter?

2016 ◽  
Vol 13 (4) ◽  
pp. A1-A3 ◽  
Author(s):  
Raju Karuppal
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Kinematic Alignment ◽  
Total Knee

scholarly journals What you need to know about kinematic alignment for total knee arthroplasty

2020 ◽  
pp. 102773
Author(s):  
Charles Rivière ◽  
Loic Villet ◽  
Dragan Jeremic ◽  
Pascal-André Vendittoli
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Kinematic Alignment ◽  
Total Knee

scholarly journals Anatomic Versus Mechanically Aligned Total Knee Arthroplasty for Unicompartmental Knee Arthroplasty Revision

2016 ◽  
Vol 10 (1) ◽  
pp. 357-363 ◽  
Author(s):  
Panagiota Toliopoulos ◽  
Marc-Andre LeBlanc ◽  
Jonathan Hutt ◽  
Martin Lavigne ◽  
Francois Desmeules ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Womac Score ◽  
Kinematic Alignment ◽  
Mechanical Alignment ◽  
Medial Proximal Tibial Angle ◽  
Alignment Technique ◽  
Total Knee ◽  
Small Patient

Objectives:The purpose of this study was to compare the intra-operative benefits and the clinical outcomes from kinematic or mechanical alignment for total knee arthroplasty (TKA) in patients undergoing revision of failed unicompartmental kneel arthroplasty (UKA) to TKA.Methods:Ten revisions were performed with a kinematic alignment technique and 11 with a mechanical alignment. Measurements of the hip-knee-ankle angle (HKA), the lateral distal femoral angle (LDFA), and the medial proximal tibial angle (MPTA) were performed using long-leg radiographs. The need for augments, stems, and constrained inserts was compared between groups. Clinical outcomes were compared using the WOMAC score along with maximum distance walked as well as knee range of motion obtained prior to discharge. All data was obtained by a retrospective review of patient files.Results:The kinematic group required less augments, stems, and constrained inserts than the mechanical group and thinner polyethylene bearings. There were significant differences in the lateral distal femoral angle (LDFA) and the medial proximal tibial angle (MPTA) between the two groups (p<0.05). The mean WOMAC score obtained at discharge was better in the kinematic group as was mean knee flexion. At last follow up of 34 months for the kinematic group and 58 months for the mechanical group, no orthopedic complications or reoperations were recorded.Conclusion:Although this study has a small patient cohort, our results suggest that kinematic alignment for TKA after UKA revision is an attractive method. Further studies are warranted.

scholarly journals Combining kinematic alignment and medial stabilized design in total knee arthroplasty: Basic rationale and preliminary clinical evidences

2020 ◽  
Vol 21 ◽  
pp. 427-431
Author(s):  
Salvatore Risitano ◽  
Luigi Sabatini ◽  
Luca Barberis ◽  
Federico Fusini ◽  
Michele Malavolta ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Kinematic Alignment ◽  
Total Knee

Patient satisfaction following total knee arthroplasty using restricted kinematic alignment

2021 ◽  
Vol 103-B (6 Supple A) ◽  
pp. 59-66
Author(s):  
Sarag Abhari ◽  
Thomas M. Hsing ◽  
Max M. Malkani ◽  
Austin F. Smith ◽  
Langan S. Smith ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Knee Arthroplasty ◽  
Varus Deformity ◽  
Advanced Technology ◽  
Kinematic Alignment ◽  
Mechanical Alignment ◽  
Entire Cohort ◽  
Total Knee

Aims Alternative alignment concepts, including kinematic and restricted kinematic, have been introduced to help improve clinical outcomes following total knee arthroplasty (TKA). The purpose of this study was to evaluate the clinical results, along with patient satisfaction, following TKA using the concept of restricted kinematic alignment. Methods A total of 121 consecutive TKAs performed between 11 February 2018 to 11 June 2019 with preoperative varus deformity were reviewed at minimum one-year follow-up. Three knees were excluded due to severe preoperative varus deformity greater than 15°, and a further three due to requiring revision surgery, leaving 109 patients and 115 knees to undergo primary TKA using the concept of restricted kinematic alignment with advanced technology. Patients were stratified into three groups based on the preoperative limb varus deformity: Group A with 1° to 5° varus (43 knees); Group B between 6° and 10° varus (56 knees); and Group C with varus greater than 10° (16 knees). This study group was compared with a matched cohort of 115 TKAs and 115 patients using a neutral mechanical alignment target with manual instruments performed from 24 October 2016 to 14 January 2019. Results Mean overall patient satisfaction for the entire cohort was 4.7 (SE 0.1) on a 5-point Likert scale, with 93% being either very satisfied or satisfied compared with a Likert of 4.3 and patient satisfaction of 81% in the mechanical alignment group (p < 0.001 and p < 0.006 respectively). At mean follow-up of 17 months (11 to 27), the mean overall Likert, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, Western Ontario and McMaster Universities Osteoarthritis Index, Forgotten Joint Score, and Knee Society Knee and Function Scores were significantly better in the kinematic group than in the neutral mechanical alignment group. The most common complication in both groups was contracture requiring manipulation under anaesthesia, involving seven knees (6.1%) in the kinematic group and nine knees (7.8%) in the mechanical alignment group. Conclusion With the advent of advanced technology, and the ability to obtain accurate bone cuts, the target limb alignment, and soft-tissue balance within millimetres, using a restricted kinematic alignment concept demonstrated excellent patient satisfaction following primary TKA. Longer-term analysis is required as to the durability of this method. Cite this article: Bone Joint J 2021;103-B(6 Supple A):59–66.

Alignment in total knee arthroplasty

2020 ◽  
Vol 102-B (3) ◽  
pp. 276-279 ◽  
Author(s):  
Sam Oussedik ◽  
Matthew P. Abdel ◽  
Jan Victor ◽  
Mark W. Pagnano ◽  
Fares S. Haddad
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Kinematic Alignment ◽  
Hybrid Technique ◽  
Soft Tissue Envelope ◽  
The Past ◽  
Robotic Assisted Surgery ◽  
Total Knee ◽  
Implant Alignment

Dissatisfaction following total knee arthroplasty is a well-documented phenomenon. Although many factors have been implicated, including modifiable and nonmodifiable patient factors, emphasis over the past decade has been on implant alignment and stability as both a cause of, and a solution to, this problem. Several alignment targets have evolved with a proliferation of techniques following the introduction of computer and robotic-assisted surgery. Mechanical alignment targets may achieve mechanically-sound alignment while ignoring the soft tissue envelope; kinematic alignment respects the soft tissue envelope while ignoring the mechanical environment. Functional alignment is proposed as a hybrid technique to allow mechanically-sound, soft tissue-friendly alignment targets to be identified and achieved. Cite this article: Bone Joint J 2020;102-B(3):276–279.

scholarly journals Total knee arthroplasty according to the original knee phenotypes with kinematic alignment surgical technique—early clinical and functional outcomes

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng-En Hsu ◽  
Jen-Ting Huang ◽  
Kwok-Man Tong ◽  
Kui-Chou Huang
Keyword(s):  
Total Knee Arthroplasty ◽  
Surgical Technique ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Functional Improvement ◽  
Kinematic Alignment ◽  
Varus Alignment ◽  
Operative Planning ◽  
Total Knee ◽  
One Year

Abstract Background The kinematic alignment (KA) technique in total knee arthroplasty (TKA) aims to restore the native alignment of pre-disease knee joint anatomy. Determining the individualized alignment targets is crucial for pre-operative planning, which can be set according to different original knee phenotypes. Five most common knee phenotypes have been categorized for KA-TKA alignment target setting in our previous study. The purpose of this study was to investigate the distribution of the five phenotypes in advanced OA knee patients and evaluate the clinical outcomes of this phenotype-oriented KA-TKA using the generic instrument, with particular emphasis on alignment strategy, surgical technique, survivorship, radiographic and functional outcomes. Methods The clinical data of 123 patients (88 women, 35 men) who had undergone 140 TKAs in our hospital were reviewed. All the TKAs were performed with alignment targets set according to the original phenotypes of the knee, with the KA method, using the generic total knee instrument. The patients’ demographics, preoperative and postoperative knee alignment angles, one-year postoperative range of motion (ROM), Oxford knee scores (OKS), Combined knee society score (CKSS) were collected and analyzed. Results The 3 years survivorship was 99.3% for all cause of revision, and 100% with revision other than infection as the endpoint. The preoperative phenotypes of the knee were as follows: neutral alignment 20.1% (type 1: 3.6%, type 2: 16.5%), varus alignment 71.2% (type 3: 46.0%, type 4: 25.2%), and valgus alignment (type 5: 8.6%). Using our protocol, patients with different knee phenotypes could get similar great functional improvement though the postoperative alignment parameters were significantly different between the knee phenotypes (P < 0.05). Conclusion The early outcomes of this phenotype-oriented KA-TKA using generic total knee instruments are promising. Setting individualized alignment target according to original knee phenotype is rational and practical. The residual varus alignment did not cause any aseptic loosening in the 3 years follow-up. Long-term survivorship and functional outcomes need to be evaluated in future studies.

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