Anatomical restoration of the anterior femoral compartment when performing KATKA: the end of the flush anterior femoral cut dogma!

Excerpt

The mechanical alignment (MA) technique has been widely used for almost half a century for implanting total knee arthroplasty (TKA). The goals of MA are to neutrally align and balance the prosthetic lower limb/knee by means of ‘systematically’ positioning the components: perpendicular to the long bones’ mechanical axis in the frontal plane, fixed posterior tibial slope, 3° external rotation of the femoral component (measured resection technique only) [5]. Whilst implants’ longevity has been shown to be good, the prosthetic joint perception often remains disappointing with ~ 50% residual knee symptoms and ~ 15% of patients being dissatisfied [2]. Due to the suspicion that poor prosthetic joint perception could be related to the systematic alteration of the native knee physiology (anatomy, laxity and biomechanics) that is unique to each individual [1, 4], the MA technique was recently challenged and new alignment techniques for TKA have been developed [5, 7]. …