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International Orthopaedics

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01-11-2015 | Original Paper

Does varus alignment adversely affect implant survival and function six years after kinematically aligned total knee arthroplasty?

Authors: Stephen M. Howell, Stelios Papadopoulos, Kyle Kuznik, Lillian R. Ghaly, Maury L. Hull

Published in: International Orthopaedics | Issue 11/2015

Abstract

Purpose

We report the six year implant survivorship, tibial component alignment and knee and limb function measured by the Oxford Knee Score and Western Ontario and McMaster Universities Osteoarthritis Index ((WOMAC) score after kinematically aligned total knee arthroplasty (TKA) and tested the hypothesis that varus alignment of the tibial component, knee, or limb does not adversely affect implant survival and function.

Methods

We prospectively followed 214 consecutive patients (219 knees) treated with a kinematically aligned TKA in 2007. Kaplan–Meier survival analysis and revision rate per 100 component years determined implant failure. The Oxford Knee Score (0 worst, 48 best) and WOMAC score (0 worst, 100 best) were used to measure function. We categorised tibial component alignment as in-range (≤ 0°) or varus (>0°), knee alignment as in-range (between -2.5° and -7.4°), varus (>-2.5°), or valgus (<-7.4°), and limb alignment as in-range (0° ± 3°), varus (>3°) or valgus (<-3°).

Results

At a mean of 6.3 years (range, 5.8–7.2), implant survivorship was 97.5 % and revision-rate per 100 component years 0.40. Three implants had been revised (deep infection one, loose tibial component one and patella instability [1); two loose patella components were pending revision and considered failures. The average Oxford Knee Score was 43 and WOMAC 91. Function of tibial components (80 %), knees (31 %) and limbs (7 %) that were aligned in varus was similar to patients aligned in-range.

Conclusions

At a mean of 6.3 years after kinematically aligned TKA, varus alignment of the tibial component, knee and limb did not adversely affect implant survival or function, which supports the consideration of kinematic alignment as an alternative to mechanical alignment for performing primary TKA.

Level of evidence, III; therapeutic study.

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Title: Does varus alignment adversely affect implant survival and function six years after kinematically aligned total knee arthroplasty?
Authors: Stephen M. Howell
Stelios Papadopoulos
Kyle Kuznik
Lillian R. Ghaly
Maury L. Hull
Publication date: 01-11-2015
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 11/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-015-2743-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Does varus alignment adversely affect implant survival and function six years after kinematically aligned total knee arthroplasty?

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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