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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-02-2022 | KNEE

Higher satisfaction after total knee arthroplasty using restricted inverse kinematic alignment compared to adjusted mechanical alignment

Authors: Philip Winnock de Grave, Thomas Luyckx, Kurt Claeys, Thomas Tampere, Jonas Kellens, Jacobus Müller, Paul Gunst

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2022

Abstract

Purpose

Various alignment philosophies for total knee arthroplasty (TKA) have been described, all striving to achieve excellent long-term implant survival and good functional outcomes. In recent years, in search of higher functionality and patient satisfaction, a shift towards more tailored and patient-specific alignment is seen. The purpose of this study was to describe a restricted ‘inverse kinematic alignment’ (iKA) technique, and to compare clinical outcomes of patients that underwent robotic-assisted TKA performed by restricted iKA vs. adjusted mechanical alignment (aMA).

Methods

The authors reviewed the records of a consecutive series of patients that received robotic-assisted TKA with restricted iKA (n = 40) and with aMA (n = 40). Oxford Knee Score (OKS) and satisfaction on a visual analogue scale (VAS) were collected at a follow-up of 12 months. Clinical outcomes were assessed according to patient acceptable symptom state (PASS) thresholds, and uni- and multivariable linear regression analyses were performed to determine associations of OKS and satisfaction with six variables (age, sex, body mass index (BMI), preoperative hip–knee–ankle (HKA) angle, preoperative OKS, alignment technique).

Results

The restricted iKA and aMA techniques yielded comparable outcome scores (p = 0.069), with OKS, respectively, 44.6 ± 3.5 and 42.2 ± 6.3. VAS Satisfaction was better (p = 0.012) with restricted iKA (9.2 ± 0.8) compared to aMA (8.5 ± 1.3). The number of patients that achieved OKS and satisfaction PASS thresholds was significantly higher (p = 0.049 and p = 0.003, respectively) using restricted iKA (98% and 80%) compared to aMA (85% and 48%). Knees with preoperative varus deformity, achieved significantly (p = 0.025) better OKS using restricted iKA (45.4 ± 2.0) compared to aMA (41.4 ± 6.8). Multivariable analyses confirmed better OKS (β = 3.1; p = 0.007) and satisfaction (β = 0.73; p = 0.005) with restricted iKA.

Conclusions

The results of this study suggest that restricted iKA and aMA grant comparable clinical outcomes at 12-month follow-up, though a greater proportion of knees operated by restricted iKA achieved the PASS thresholds for OKS and satisfaction. Notably. in knees with preoperative varus deformity, restricted iKA yielded significantly better OKS and satisfaction than aMA.

Level of evidence

Level III, comparative study.

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Title: Higher satisfaction after total knee arthroplasty using restricted inverse kinematic alignment compared to adjusted mechanical alignment
Authors: Philip Winnock de Grave
Thomas Luyckx
Kurt Claeys
Thomas Tampere
Jonas Kellens
Jacobus Müller
Paul Gunst
Publication date: 01-02-2022
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2022
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-020-06165-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Higher satisfaction after total knee arthroplasty using restricted inverse kinematic alignment compared to adjusted mechanical alignment

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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