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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2013

01-10-2013 | Knee

Accurate alignment and high function after kinematically aligned TKA performed with generic instruments

Authors: Stephen M. Howell, Stelios Papadopoulos, Kyle T. Kuznik, Maury L. Hull

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2013

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Abstract

Purpose

Performing kinematically aligned total knee arthroplasty (TKA) with generic instruments is less costly than patient-specific instrumentation; however, the alignment and function with this new technique are unknown.

Methods

One hundred and one consecutive patients (101 knees) treated with kinematically aligned TKA, implanted with use of generic instruments, were prospectively followed. The medial collateral ligament was not released. The lateral collateral ligament was released in the 17 % of patients with a fixed valgus deformity. Six measures of alignment were categorized from a scanogram of the extremity, an axial scan of the knee, and an intraoperative measurement. Both the Oxford Knee and WOMAC™ scores were assessed as function. High function was a mean Oxford Knee score >41.

Results

The frequency that patients were categorized as in-range was 93 % for the mechanical alignment of the limb (0° ± 3°), 94 % for the joint line (−3° ± 3°), 57 % for the anatomic axis of the knee (−2.5° ± −7.4° valgus), 4 % for the varus–valgus rotation of the tibial component (≤0° valgus), 98 % for the rotation of the tibial component with respect to the femoral component (0° ± 10°), and 94 % for the intraoperative change in the anterior–posterior distance of the tibia with respect to the femur at 90° of flexion (0 ± 2 mm). The mean OKS score was 42, and WOMAC™ score was 89. For each alignment, the function was the same for patients categorized as an outlier or in-range.

Conclusions

The authors prefer the use of generic instruments to perform kinematically aligned TKA in place of mechanically aligned TKA because five of six alignments were accurate and because high function was restored regardless of whether patients had an alignment categorized as an outlier or in-range.

Level of evidence

IV.
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Metadata
Title
Accurate alignment and high function after kinematically aligned TKA performed with generic instruments
Authors
Stephen M. Howell
Stelios Papadopoulos
Kyle T. Kuznik
Maury L. Hull
Publication date
01-10-2013
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2621-x

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