Does Postoperative Mechanical Axis Alignment Have an Effect on Clinical Outcome of Primary Total Knee Arthroplasty? A Retrospective Cohort Study

Salzmann, Mikhail; Fennema, Peter; Becker, Roland; Hommel, Hagen

doi:10.2174/1874325001711011330

Cited by 21 publications

(33 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, Magnussen et al 21 concluded that residual varus alignment does not compromise the clinical and functional outcome. These results are in line with a current retrospective cohort study by Salzmann et al 22 The authors found that residual postoperative varus alignment in TKA does not appear to adversely affect clinical outcome in patients with preoperative varus osteoarthritis. Some limitation of the aforementioned study was the small number of cases (varus to varus ¼ 18 cases) and the follow-up of 2 years.…”

Section: Discussionsupporting

confidence: 91%

“…However, the design of our study is comparable to the existing literature concerning this topic. 22 Our results support the assumption that correction of varus knees to a neutral coronal alignment in TKA seems to be problematic and that keeping a slight varus as the natural alignment could be beneficial. In the KOOS, the naturally corrected group had a better outcome compared with the neutrally corrected group.…”

Section: Discussionsupporting

confidence: 83%

See 1 more Smart Citation

Neutral or Natural? Functional Impact of the Coronal Alignment in Total Knee Arthroplasty

Schiffner

Wild

Regenbrecht³

et al. 2018

J Knee Surg

View full text Add to dashboard Cite

Total knee arthroplasty (TKA) is a very successful procedure. The alignment in TKA has been identified as being of importance to prevent early implant failure and patient dissatisfaction. Our hypothesis was that patients with a preoperative varus deformation remaining in a slight varus alignment as their natural alignment after TKA will have superior clinical results compared with patients who are restored in neutral alignment. A total of 115 patients were corrected from varus to neutral (varus-neutral) and in 33 patients a preoperative varus alignment was kept in varus (varus). Standardized preoperative and postoperative full-length hip-knee-ankle radiographs under full weight-bearing conditions were performed in all patients. The patients' knees were categorized preoperatively and postoperatively based on the angle between mechanical femoral axis and mechanical tibial axis. Knees with alignment between ± 3 degrees were categorized as neutrally aligned, whereas alignment within ≤ -3 degrees was categorized as varus. The Knee Injury Osteoarthritis Outcome Score (KOOS) and Oxford Knee Score were determined retrospectively. The varus group scored significantly better in total KOOS ( < 0.05) compared with the varus-neutral group. Also, a trend was visible in the Oxford Knee Score but this was not significant ( > 0.05). This trend was even more evident in varus knees which were slightly undercorrected. The results support the assumption that leaving a residual varus alignment after TKA leads to better functional outcomes in TKA for patients with preoperative varus osteoarthritis.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 83%

Neutral or Natural? Functional Impact of the Coronal Alignment in Total Knee Arthroplasty

Schiffner

Wild

Regenbrecht³

et al. 2018

J Knee Surg

View full text Add to dashboard Cite

show abstract

“…Other reports show the same situation. It has been reported that residual varus alignment after TKA in varus knees is acceptable, but valgus alignment after TKA in varus knees is not allowed. To avoid unacceptable valgus malalignment after TKA in varus knees, surgeons may potentially restore a little bit of varus alignment as they see fit.…”

Section: Discussionmentioning

confidence: 87%

Improving Tibial Component Coronal Alignment During Total Knee Arthroplasty with the Use of a Double‐Check Technique

Wang

Liang

et al. 2019

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectiveTo compare the efficacy of the restoration of tibial component coronal alignment with a double‐check technique and the conventional surgical technique during total knee arthroplasty (TKA) in knee osteoarthritis patients, and to investigate the distribution of the medial proximal tibial angle (MPTA) after TKA.MethodsA retrospective review was performed of 151 patients (179 knees) with knee osteoarthritis undergoing primary TKA in Beijing Chaoyang Hospital, Capital Medical University from February 2013 to January 2015 to evaluate the differences in MPTA in patients undergoing the conventional TKA and those undergoing a modified TKA with a double‐check technique after the surgery. All patients were evaluated by MPTA, range of motion (ROM), Knee Society Clinical Rating System (KSS) clinical scores, and KSS functional scores. An MPTA deviation of 3° or greater was considered malalignment.ResultsA total of 130 TKA procedures in 119 patients were included in the study: 64 knees treated with conventional TKA and 66 knees treated with the double‐check technique TKA. The mean postoperative MPTA was 88.6° ± 2.2° in the conventional TKA group and 89.1° ± 1.5° in the double‐check TKA group. The mean postoperative MPTA between the two groups was not significantly different. In the conventional TKA group, 79.7% (51 knees) had a postoperative MPTA deviation within 3° and 20.3% (13 knees) had a MPTA deviation greater than 3°. In the double‐check TKA group, 93.9% (62 knees) had a postoperative MPTA deviation within 3°and 6.1% (4 knees) had a MPTA deviation greater than 3°. The postoperative MPTA deviation within 3° showed a statistically significant difference between the two groups. In the double‐check TKA group, a 21.2% (14 knees) tibial malalignment was detected after the first check and a 9.1% (6 knees) tibial malalignment was detected after the second check. The mean postoperative ROM was 118.1° ± 9.2° in the conventional TKA group and 115.7° ± 10.1° in the double‐check TKA group. The mean postoperative KSS clinical score was 89.3 ± 3.5 in the conventional TKA group and 89.0 ± 3.7 in the double‐check TKA group. The mean postoperative KSS functional score was 84.8 ± 10.0 in the conventional TKA group and 84.9 ± 9.0 in the double‐check TKA group. The mean postoperative ROM, KSS clinical scores, and KSS functional scores between the two groups were not statistically significantly different.ConclusionMalalignment of the tibial component can occur after conventional TKA, and the double‐check technique is an effective method to improve tibial component coronal alignment.

show abstract

“…Hungerford ve Krackow tarafından 1980'lerde ileri sürülen bu konsepte göre, TDA sırasında kemik kesileri sistematik olarak, doğal anatomiye uygun şekilde yapılmalıdır. [19] Distal femoral kesi 9° valgusta, FK yerleşiminde 3 mm'yi aşan taşmalar önlenmeli; TK'nin tibial kesi yüzeyini azami örtmesi sağlanırken taşmalar asgari düzeyde tutulmalıdır.…”

Section: Anatomik Dizilimunclassified

Total diz artroplastisinde dizilim, komponent boyut ve yerleşim sorunları

Kayaokay¹,

Aydoğdu²

2019

TOTBID

View full text Add to dashboard Cite

Does Postoperative Mechanical Axis Alignment Have an Effect on Clinical Outcome of Primary Total Knee Arthroplasty? A Retrospective Cohort Study

Cited by 21 publications

References 31 publications

Neutral or Natural? Functional Impact of the Coronal Alignment in Total Knee Arthroplasty

Neutral or Natural? Functional Impact of the Coronal Alignment in Total Knee Arthroplasty

Improving Tibial Component Coronal Alignment During Total Knee Arthroplasty with the Use of a Double‐Check Technique

Total diz artroplastisinde dizilim, komponent boyut ve yerleşim sorunları

Contact Info

Product

Resources

About