Kinematic alignment is a possible alternative to mechanical alignment in total knee arthroplasty

Lee, Yong Seuk; Howell, Stephen M.; Won, Ye Yeon; Lee, O-Sung; Lee, Jun Young; Vahedi, Homayoon; Teo, Seow Hui

doi:10.1007/s00167-017-4558-y

Cited by 149 publications

(111 citation statements)

References 36 publications

(96 reference statements)

Supporting

Mentioning

103

Contrasting

Unclassified

Order By: Relevance

“…[3][4][5][6] Metaanalyses comparing kinematically and mechanically aligned TKA judged that the functional outcome, as measured with the Knee Society score (KSS), favored kinematically aligned TKA in a short-term follow-up period. [7][8][9] Implantation of classic mechanical alignment is aligning the femoral and tibial component perpendicular to the mechanical axis. In kinematic alignment, however, the principles are coaligning the transverse axis of the best-fitting femoral component with the primary transverse axis in the femur and placing the tibial component, so that the longitudinal axis of the tibia is perpendicular to the transverse axis in the femur.…”

mentioning

confidence: 99%

Intraoperative Soft Tissue Balance/Kinematics and Clinical Evaluation of Modified Kinematically versus Mechanically Aligned Total Knee Arthroplasty

et al. 2019

View full text Add to dashboard Cite

AbstractRecently, kinematically aligned total knee arthroplasty has been found to achieve better clinical outcomes than mechanically aligned TKA. Despite the good clinical outcomes that are reported at short- to mid-term follow-up, intraoperative variables that are associated with a better outcome have not been measured. Therefore, this study was conducted to compare intraoperative kinematics/soft tissue balance and the clinical outcomes of patients who underwent modified kinematically (restricted tibial cut) or mechanically aligned total knee arthroplasty. Sixty cruciate-retaining total knee arthroplasties (30 modified kinematically [3-degree varus and 7-degree posterior slope in tibial cut] and 30 mechanically aligned) were performed in patients with varus-type osteoarthritis using a navigation system. Intraoperative kinematics assessed by the navigation system and soft tissue balance assessed by an offset-type tensor were compared between the groups. One year postoperatively, the range of motion and 2011 Knee Society scores were compared between the groups. Kinematic assessment exhibited that tibial internal rotation during flexion was significantly maintained in the kinematic compared with the mechanical group (p < 0.05). Varus/valgus ligament balance at 90 and 120 degrees of flexion significantly maintained lateral laxity in the kinematic compared with the mechanical group (p < 0.05). Improvement of flexion angles, functional activity scores, and patient satisfaction were significantly better in the kinematic than in the mechanical group (p < 0.05). Modified kinematically aligned cruciate-retaining total knee arthroplasty maintained more tibial internal rotation and lateral laxity during flexion than mechanically aligned total knee arthroplasty; thus, the former may result in better clinical outcomes.

show abstract

mentioning

confidence: 99%

Intraoperative Soft Tissue Balance/Kinematics and Clinical Evaluation of Modified Kinematically versus Mechanically Aligned Total Knee Arthroplasty

et al. 2019

View full text Add to dashboard Cite

show abstract

“… 2012 , Lee et al. 2017 ), and that the increased need for ligament balancing in mechanically aligned varus knees can be detrimental to the functional outcome (Bellemans et al. 2012 , Gu et al.…”

Section: Discussionmentioning

confidence: 99%

No detrimental effect of ligament balancing on functional outcome after total knee arthroplasty: a prospective cohort study on 129 mechanically aligned knees with 3 years’ follow-up

Aunan

Röhrl

2018

Acta Orthopaedica

View full text Add to dashboard Cite

Background and purpose — In the classical mechanical alignment technique, ligament balancing is considered a prerequisite for good function and endurance in total knee arthroplasty (TKA). However, it has been argued that ligament balancing may have a negative effect on knee function, and some authors advocate anatomic or kinematic alignment in order to reduce the extent of ligament releases. The effect of the trauma induced by ligament balancing on functional outcome is unknown; therefore, the aim of this study was to investigate this effect.Patients and methods — 129 knees (73 women) were investigated. Mean age was 69 years (42–82), and mean BMI was 29 (20–43). Preoperatively 103 knees had a varus deformity, 21 knees had valgus deformity, and 5 knees were neutral. The primary outcome measure was the Knee injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome measures were the Oxford Knee Score (OKS) and patient satisfaction (VAS). All ligament releases were registered intraoperatively and outcome at 3 years’ follow-up in knees with and without ligament balancing was comparedResults — 86 knees were ligament balanced and 43 knees were not. Ligament-balanced varus knees had more preoperative deformity than varus knees without ligament balancing (p = 0.01). There were no statistically significant differences in outcomes between ligament-balanced and non-ligament-balanced knees at 3 years’ follow-up. No correlation was found between increasing numbers of soft tissue structures released and outcome.Interpretation — We did not find any negative effect of the trauma induced by ligament balancing on knee function after 3 years.

show abstract

“…[5][6][7] ve sağkalım oranları belirlenmiş; bu tekniğin mekanik dizilim konseptine "kabul edilebilir bir alternatif" oluşturduğu sonucuna varılmıştır. [23] Ancak, kinematik dizilimli TDA uygulamalarının getirdiği bazı sorunlar da ortaya çıkmaya başlamıştır. Özellikle, ileri anatomik bozukluk gösteren dizlerde kullanımı sorunlu görünmektedir.…”

Section: Femoral Komponent Rotasyonel Dizilimiunclassified

Total diz artroplastisinde dizilim, komponent boyut ve yerleşim sorunları

Kayaokay¹,

Aydoğdu²

2019

TOTBID

View full text Add to dashboard Cite

Kinematic alignment is a possible alternative to mechanical alignment in total knee arthroplasty

Abstract: Level II.

Cited by 149 publications

References 36 publications

Intraoperative Soft Tissue Balance/Kinematics and Clinical Evaluation of Modified Kinematically versus Mechanically Aligned Total Knee Arthroplasty

Intraoperative Soft Tissue Balance/Kinematics and Clinical Evaluation of Modified Kinematically versus Mechanically Aligned Total Knee Arthroplasty

No detrimental effect of ligament balancing on functional outcome after total knee arthroplasty: a prospective cohort study on 129 mechanically aligned knees with 3 years’ follow-up

Total diz artroplastisinde dizilim, komponent boyut ve yerleşim sorunları

Contact Info

Product

Resources

About