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07.06.2020 | Leitthema

Current evidence base for kinematic alignment

verfasst von: L.-R. Tuecking, P. Savov, H. Windhagen, M. Ettinger

Erschienen in: Die Orthopädie | Ausgabe 7/2020

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Abstract

Background

Kinematic alignment recently became an alternative alignment option for total knee arthroplasty (TKA). Beside previous studies assessing mechanical alignment in comparison to unintentional malalignment of TKA in terms of implant survival and clinical outcome, more and more studies have focused on the direct comparison of intentional kinematic alignment with mechanical alignment of the prosthesis. In the past 5 years the number of studies with respect to kinematic alignment has risen from 11 to 91 studies.

Aim

The aim of this review article is to give a narrative overview of the current literature in the debate concerning kinematic and mechanical alignment in TKA.

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10.

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11.

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12.

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13.

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14.

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15.

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16.

Howell SM, Shelton TJ, Hull ML (2018) Implant survival and function ten years after kinematically aligned total knee arthroplasty. J Arthroplasty 33:3678–3684. https://doi.org/10.1016/j.arth.2018.07.020 CrossRefPubMed

17.

Ishikawa M, Kuriyama S, Ito H, Furu M, Nakamura S, Matsuda S (2015) Kinematic alignment produces near-normal knee motion but increases contact stress after total knee arthroplasty: a case study on a single implant design. Knee 22:206–212. https://doi.org/10.1016/j.knee.2015.02.019 CrossRefPubMed

18.

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19.

Ji H‑M, Han J, Jin DS, Seo H, Won Y‑Y (2016) Kinematically aligned TKA can align knee joint line to horizontal. Knee Surg Sports Traumatol Arthrosc 24:2436–2441. https://doi.org/10.1007/s00167-016-3995-3 CrossRefPubMed

20.

Khatib Y, Xia A, Naylor JM, Harris IA, Sorial RM (2019) Different targets of mechanical alignment do not improve knee outcomes after TKA. Knee 26:1395–1402. https://doi.org/10.1016/j.knee.2019.08.004 CrossRefPubMed

21.

Kim J‑T, Han J, Lim S, Shen QH, Won YY (2019) Kinematically aligned TKA aligns the ankle joint line closer to those of the native ankle than mechanically aligned TKA in bipedal stance. J Knee Surg 32:1033–1038. https://doi.org/10.1055/s-0039-1694796 CrossRefPubMed

22.

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23.

Kim Y‑H, Park J‑W, Kim J‑S, Park S‑D (2014) The relationship between the survival of total knee arthroplasty and postoperative coronal, sagittal and rotational alignment of knee prosthesis. International Orthopaedics (SICOT) 38:379–385. https://doi.org/10.1007/s00264-013-2097-9 CrossRef

24.

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25.

Laende EK, Richardson CG, Dunbar MJ (2019) A randomized controlled trial of tibial component migration with kinematic alignment using patient-specific instrumentation versus mechanical alignment using computer-assisted surgery in total knee arthroplasty. Bone Joint J 101-B:929–940. https://doi.org/10.1302/0301-620X.101B8.BJJ-2018-0755.R3 CrossRefPubMed

26.

Li Y‑R, Gao Y‑H, Yang C, Ding L, Zhang X, Chen H, Liu J, Qi X (2019) Finite-element analysis of the proximal tibial sclerotic bone and different alignment in total knee arthroplasty. BMC Musculoskelet Disord 20:617. https://doi.org/10.1186/s12891-019-3008-z CrossRefPubMedPubMedCentral

27.

Liau J‑J, Cheng C‑K, Huang C‑H, Lo W‑H (2002) The effect of malalignment on stresses in polyethylene component of total knee prostheses—a finite element analysis. Clin Biomech 17:140–146. https://doi.org/10.1016/S0268-0033(01)00109-7 CrossRef

28.

Lotke PA, Ecker ML (1977) Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg Am 59:77–79CrossRefPubMed

29.

Luyckx T, Vandenneucker H, Ing LS, Vereecke E, Ing AV, Victor J (2018) Raising the joint line in TKA is associated with mid-flexion laxity: a study in cadaver knees. Clin Orthop Relat Res 476:601–611. https://doi.org/10.1007/s11999.0000000000000067 CrossRefPubMedPubMedCentral

30.

MacDessi SJ, Griffiths-Jones W, Chen DB, Griffiths-Jones S, Wood JA, Diwan AD, Harris IA (2020) Restoring the constitutional alignment with a restrictive kinematic protocol improves quantitative soft-tissue balance in total knee arthroplasty: a randomized controlled trial. Bone Joint J 102-B:117–124. https://doi.org/10.1302/0301-620X.102B1.BJJ-2019-0674.R2 CrossRefPubMed

31.

Magnussen RA, Weppe F, Demey G, Servien E, Lustig S (2011) Residual varus alignment does not compromise results of TKAs in patients with preoperative varus. Clin Orthop Relat Res 469:3443–3450. https://doi.org/10.1007/s11999-011-1988-6 CrossRefPubMedPubMedCentral

32.

Matsuda S, Whiteside LA, White SE (1999) The effect of varus tilt on contact stresses in total knee arthroplasty: a biomechanical study. Orthopedics 22:303–307PubMed

33.

Matsumoto T, Takayama K, Ishida K, Hayashi S, Hashimoto S, Kuroda R (2017) Radiological and clinical comparison of kinematically versus mechanically aligned total knee arthroplasty. Bone Joint J 99-B:640–646. https://doi.org/10.1302/0301-620X.99B5.BJJ-2016-0688.R2 CrossRefPubMed

34.

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35.

Matziolis G, Adam J, Perka C (2010) Varus malalignment has no influence on clinical outcome in midterm follow-up after total knee replacement. Arch Orthop Trauma Surg 130:1487–1491. https://doi.org/10.1007/s00402-010-1064-9 CrossRefPubMed

36.

McEwen PJ, Dlaska CE, Jovanovic IA, Doma K, Brandon BJ (2019) Computer-assisted kinematic and mechanical axis total knee arthroplasty: a prospective randomized controlled trial of bilateral simultaneous surgery. J Arthroplasty. https://doi.org/10.1016/j.arth.2019.08.064 CrossRefPubMed

37.

Morgan SS, Bonshahi A, Pradhan N, Gregory A, Gambhir A, Porter ML (2008) The influence of postoperative coronal alignment on revision surgery in total knee arthroplasty. Int Orthop 32:639–642. https://doi.org/10.1007/s00264-007-0391-0 CrossRefPubMed

38.

Nakajima A, Sonobe M, Akatsu Y, Aoki Y, Takahashi H, Suguro T, Nakagawa K (2018) Association between limb alignment and patient-reported outcomes after total knee arthroplasty using an implant that reproduces anatomical geometry. J Orthop Surg Res 13:320. https://doi.org/10.1186/s13018-018-1030-8 CrossRefPubMedPubMedCentral

39.

Nakamura S, Tian Y, Tanaka Y, Kuriyama S, Ito H, Furu M, Matsuda S (2017) The effects of kinematically aligned total knee arthroplasty on stress at the medial tibia: a case study for varus knee. Bone Joint Res 6:43–51. https://doi.org/10.1302/2046-3758.61.BJR-2016-0090.R1 CrossRefPubMedPubMedCentral

40.

Ng CK, Chen JY, Yeh JZY, Ho JPY, Merican AM, Yeo SJ (2018) Distal femoral rotation correlates with proximal tibial joint line obliquity: a consideration for kinematic total knee arthroplasty. J Arthroplasty 33:1936–1944. https://doi.org/10.1016/j.arth.2017.12.025 CrossRefPubMed

41.

Niki Y, Nagura T, Kobayashi S, Udagawa K, Harato K (2019) Who will benefit from kinematically aligned total knee arthroplasty? Perspectives on patient-reported outcome measures. J Arthroplasty. https://doi.org/10.1016/j.arth.2019.09.035 CrossRefPubMed

42.

Niki Y, Nagura T, Nagai K, Kobayashi S, Harato K (2018) Kinematically aligned total knee arthroplasty reduces knee adduction moment more than mechanically aligned total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 26:1629–1635. https://doi.org/10.1007/s00167-017-4788-z CrossRefPubMed

43.

Nishida K, Matsumoto T, Takayama K, Ishida K, Nakano N, Matsushita T, Kuroda R, Kurosaka M (2017) Remaining mild varus limb alignment leads to better clinical outcome in total knee arthroplasty for varus osteoarthritis. Knee Surg Sports Traumatol Arthrosc 25:3488–3494. https://doi.org/10.1007/s00167-016-4260-5 CrossRefPubMed

44.

Pang H‑N, Jamieson P, Teeter MG, McCalden RW, Naudie DDR, MacDonald SJ (2014) Retrieval analysis of posterior stabilized polyethylene tibial inserts and its clinical relevance. J Arthroplasty 29:365–368. https://doi.org/10.1016/j.arth.2013.05.029 CrossRefPubMed

45.

Park J‑K, Seon J‑K, Cho K‑J, Lee N‑H, Song E‑K (2018) Is immediate postoperative mechanical axis associated with the revision rate of primary total knee arthroplasty? A 10-year follow-up study. Clin Orthop Surg 10:167. https://doi.org/10.4055/cios.2018.10.2.167 CrossRefPubMedPubMedCentral

46.

Parratte S, Pagnano MW, Trousdale RT, Berry DJ (2010) Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements. J Bone Joint Surg Am 92:2143–2149. https://doi.org/10.2106/JBJS.I.01398 CrossRefPubMed

47.

Perillo-Marcone A, Barrett DS, Taylor M (2000) The importance of tibial alignment. J Arthroplasty 15:1020–1027. https://doi.org/10.1054/arth.2000.17941 CrossRefPubMed

48.

Petterwood J, Dowsey MM, Rodda D, Choong PFM (2014) The immediate post-operative radiograph is an unreliable measure of coronal plane alignment in total knee replacement. Front Surg. https://doi.org/10.3389/fsurg.2014.00035 CrossRefPubMedPubMedCentral

49.

Rassir R, van de Bunt F, Sierevelt IN, Nolte PA (2019) The value of postoperative prosthesis alignment and patellar height measurements on standard X‑rays after total knee arthroplasty: Does it relate to knee function after 5 years? Knee 26:213–221. https://doi.org/10.1016/j.knee.2018.09.014 CrossRefPubMed

50.

Ritter MA, Davis KE, Meding JB, Pierson JL, Berend ME, Malinzak RA (2011) The effect of alignment and BMI on failure of total knee replacement. J Bone Joint Surg Am 93:1588–1596. https://doi.org/10.2106/JBJS.J.00772 CrossRefPubMed

51.

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52.

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53.

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54.

Salzmann M, Fennema P, Becker R, Hommel H (2017) Does postoperative mechanical axis alignment have an effect on clinical outcome of primary total knee arthroplasty? A retrospective cohort study. Open Orthop J 11:1330–1336. https://doi.org/10.2174/1874325001711011330 CrossRefPubMedPubMedCentral

55.

Shelton TJ, Gill M, Athwal G, Howell SM, Hull ML (2019) Outcomes in patients with a calipered kinematically aligned TKA that already had a contralateral mechanically aligned TKA. J Knee Surg. https://doi.org/10.1055/s-0039-1693000 CrossRefPubMed

56.

Shelton TJ, Nedopil AJ, Howell SM, Hull ML (2017) Do varus or valgus outliers have higher forces in the medial or lateral compartments than those which are in-range after a kinematically aligned total knee arthroplasty?: Limb and joint line alignment after kinematically aligned total knee arthroplasty. Bone Joint J 99-B:1319–1328. https://doi.org/10.1302/0301-620X.99B10.BJJ-2017-0066.R1 CrossRefPubMed

57.

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58.

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59.

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60.

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63.

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64.

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65.

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66.

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67.

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Titel: Current evidence base for kinematic alignment
verfasst von: L.-R. Tuecking
P. Savov
H. Windhagen
M. Ettinger
Publikationsdatum: 07.06.2020
Verlag: Springer Medizin
Erschienen in: Die Orthopädie / Ausgabe 7/2020
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI: https://doi.org/10.1007/s00132-020-03932-6

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