Kinematic alignment in total knee arthroplasty

Sohail Nisar; Jeya Palan; Charles Rivière; Mark Emerton; Hemant Pandit

doi:10.1302/2058-5241.5.200010

Kinematic alignment in total knee arthroplasty

EFORT Open Rev. 2020 Aug 1;5(7):380-390. doi: 10.1302/2058-5241.5.200010. eCollection 2020 Jul.

Authors

Sohail Nisar^{1

2

3}, Jeya Palan³, Charles Rivière^{4

5

6}, Mark Emerton³, Hemant Pandit^{1

3}

Affiliations

¹ Leeds Institute of Rheumatic and Musculoskeletal Medicine, UK.
² Academic Department of Trauma and Orthopaedics, LGI, University of Leeds, Leeds, UK.
³ Leeds Teaching Hospitals Trust, UK.
⁴ MSK Lab - Imperial College London, White City Campus, London, UK.
⁵ The Lister Hospital, Chelsea Bridge, London, UK.
⁶ Centre de l'Arthrose - Clinique du Sport, Bordeaux-Mérignac, France.

Abstract

Kinematic alignment (KA) is an alternative philosophy for aligning a total knee replacement (TKR) which aims to restore all three kinematic axes of the native knee.Many of the studies on KA have actually described non-KA techniques, which has led to much confusion about what actually fits the definition of KA.Alignment should only be measured using three-dimensional cross-sectional imaging. Many of the studies looking at the influence of implants/limb alignment on total knee arthroplasty outcomes are of limited value because of the use of two-dimensional imaging to measure alignment, potentially leading to inaccuracy.No studies have shown KA to be associated with higher complication rates or with worse implant survival; and the clinical outcomes following KA tend to be at least as good as mechanical alignment.Further high-quality multi-centre randomized controlled trials are needed to establish whether KA provides better function and without adversely impacting implant survival. Cite this article: EFORT Open Rev 2020;5:380-390. DOI: 10.1302/2058-5241.5.200010.

Keywords: arthroplasty; kinematic alignment; knee.

Publication types

Review