Kinematically aligned TKA can align knee joint line to horizontal

Ji, Hyung-Min; Han, Jun; Jin, Dong San; Seo, Hyunseok; Won, Ye Yeon

doi:10.1007/s00167-016-3995-3

Cited by 82 publications

(81 citation statements)

References 28 publications

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“…The pooled mean difference in TCRTMA was 2.25°(95% CI: 1.56-2.95°P < .0001; I 2 = 0%, Fig. 6), indicating that the TCRTMA was significantly more varus with the KA technique [18] 2016 RCS 65 65 N/S KA: N/S MA: N/S 6 JLOA Young et al [19] 2016 …”

Section: Overall Radiographic Outcomementioning

confidence: 99%

“…This eventually resulted in 6 studies that were included in the meta-analysis. [14][15][16][17][18][19] 3.2. Study characteristics, patient populations, and quality assessment of the included studies The 6 studies we examined included 371 patients who underwent primary TKA through the KA technique and 372 patients who underwent primary TKA through the MA technique.…”

Section: Identification Of Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Kinematic and Mechanical Alignment Techniques in Primary Total Knee Arthroplasty: A Meta-Analysis

Yoon

Shin

2017

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: Overall Radiographic Outcomementioning

confidence: 99%

Section: Identification Of Studiesmentioning

confidence: 99%

Comparison of Kinematic and Mechanical Alignment Techniques in Primary Total Knee Arthroplasty: A Meta-Analysis

Yoon

Shin

2017

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…KA in the coronal and sagittal plane was achieved using a cartilage probing technique previously described. 1 Long-leg standing radiographs were taken for the control and study groups. To control the rotation and position of lower extremities for the AP radiograph, foot orientation angle and distance between both feet were positioned on a reference foot template.…”

Section: Methodsmentioning

confidence: 99%

“…[13][14][15] The general principle of KATKA is the restoration of the prearthritic knee articular surface to account for individual anatomical variation. A recent study reported the restoration of a native knee joint line which was parallel to the ground after KATKA 1,16 and additional studies show that KATKA actually restores the native forces in the medial and lateral joints. 17,18 Theoretically, restoration of the prearthritic knee articular surface would restore the relationship between the native knee and adjacent joints.…”

mentioning

confidence: 97%

“…A majority of patients with severe osteoarthritis (OA) of the knee joint have varus deformity of the knee joint as well. [1][2][3] As knee OA causes destruction of the articular surface and alteration of limb alignment, subsequent alteration in alignment and mechanical stress distribution of the ankle joint occurs. 4,5 The chronic alteration of alignment around the ankle may sequentially lead to another pathologic condition such as OA of the ankle joint.…”

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confidence: 99%

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Kinematically Aligned TKA Aligns the Ankle Joint Line Closer to Those of the Native Ankle than Mechanically Aligned TKA in Bipedal Stance

et al. 2019

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Mechanically aligned total knee arthroplasty (MATKA) aims to make alignment of the hip, knee, and ankle straight unexceptionally. However, emerging evidence suggests that unexceptional straightening the mechanical axis of the lower limb may lead to clinical and radiological problems of the ankle joint. By contrast, kinematically aligned total knee arthroplasty (KATKA) strives to restore the articular surface of the prearthritic knee. In this study, we examined results from KATKA and MATKA to determine which surgery restores the ankle joint orientation closer to the native ankle joint in bipedal stance and hypothesized that KATKA, rather than MATKA, would be more effective. Data from long-leg standing radiographs of 60 healthy adults (control group, n = 120 knees), patients who underwent MATKA (n = 90 knees), and patients who underwent KATKA (n = 90 knees) were retrospectively reviewed. The hip–knee–ankle angle, orientation of the tibial plafond and the talar dome relative to the ground (G-plafond and G-talus, respectively), and orientation of the plafond relative to the mechanical axis of the limb (M-plafond and M-talus, respectively) were measured and analyzed for comparison. Results show that bipedal stance alignment in patients who underwent KATKA (G-plafond: −0.65 ± 3.03 and G-talus: −1.72 ± 4.02) were not significantly different to native ankle joint alignment indicated by the control group. Compared with the native ankle joint measured in the control group (G-plafond: −0.76 ± 2.69 and G-talus: −1.30 ± 3.25), the tibial plafond and talar dome significantly tilted laterally relative to the ground in ankle joints after MATKA (G-plafond: −2.32 ± 3.30 and G-talus: −2.97 ± 3.98, p = 0.001 and p = 0.004, respectively). Thus, postoperative ankle joint line orientation after KATKA was horizontal to the floor and closer to that of native ankle joints than those after MATKA. The level of evidence is Level III.

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Functional knee phenotypes: A helpful classification tool for visualizing potential femoral varus in restricted kinematic alignment total knee arthroplasty in Japan

Kobayashi,

Kawaguchi,

Goto

et al. 2023

Knee surg. sports traumatol. arthrosc.

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PurposeRestricted kinematic alignment (rKA) is a modified technique of kinematically aligned total knee arthroplasty (TKA) within a safe alignment range for long‐term implant survivorship. The purpose of this study was to clarify (1) the distribution of functional knee phenotypes in patients who underwent TKA in Japan and (2) whether the application of this classification results in anatomically neutral alignment after rKA TKA.MethodsOverall, 114 TKA surgeries (mechanical alignment [MA]: 49; rKA: 65) were performed. The joint line orientation angle (JLOA), hip–knee–ankle angle (HKA), femoral mechanical angle (FMA) and tibial mechanical angle (TMA) were obtained. The knees were categorized using a functional knee phenotype classification. Clinical evaluations, including the Knee Injury and Osteoarthritis Outcome, 12‐question Forgotten Joint and Oxford Knee Scores, were performed 3 years postoperatively. Between‐group comparisons were made.ResultsThe most common preoperative functional knee phenotype was VARHKA3° + NEUFMA0° + VARTMA3° (11.4%). In the preoperative population, 51 knees (44.7%) had VARFMA ≥ 3°. Postoperatively, the most common functional knee phenotype was NEUHKA0° + VARFMA3° + VALTMA3° (14 knees, 28.6%) in the MA and NEUHKA0° + NEUFMA0° + NEUTMA0° in the rKA group. The percentage of postoperative JLOA within ±3° from the floor was 27% and 72% in the MA and rKA groups, respectively (p < 0.001). The functional knee phenotype after rKA TKA was neutrally reproduced, and the joint line was more parallel to the ground in the standing position than that of MA. Between‐group differences in clinical outcomes were not significant.ConclusionThe application of functional knee phenotyping to knee osteoarthritis in Japan suggested the presence of racial morphological characteristics. This classification could help better visualize potential femoral varus, contributing to protocol deviation in applying restricted KA TKA.Level of EvidenceLevel IV.

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Kinematically aligned TKA can align knee joint line to horizontal

Abstract: III.

Cited by 82 publications

References 28 publications

Comparison of Kinematic and Mechanical Alignment Techniques in Primary Total Knee Arthroplasty: A Meta-Analysis

Comparison of Kinematic and Mechanical Alignment Techniques in Primary Total Knee Arthroplasty: A Meta-Analysis

Kinematically Aligned TKA Aligns the Ankle Joint Line Closer to Those of the Native Ankle than Mechanically Aligned TKA in Bipedal Stance

Functional knee phenotypes: A helpful classification tool for visualizing potential femoral varus in restricted kinematic alignment total knee arthroplasty in Japan

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