[Kinematic alignment in total knee arthroplasty : Concept, evidence base and limitations]

Against the background that 20 % of patients are dissatisfied after total knee arthroplasty, there is ongoing controversy about optimal alignment. In this context, orientating the prosthetic components to the natural kinematic axes of the knee appears to be an interesting new concept.

The objective of this paper is to provide a critical review of the current literature and our own research data regarding the concept of kinematically aligned total knee arthroplasty with the current evidence base and potential limitations.

In the recent literature faster rehabilitation, better knee function, and higher patient satisfaction are described compared to conventional alignment, even if the postoperative alignment deviates more than 3° from the mechanical axis. However, the technique may not be suitable for every patient and pathology, and further research is necessary to set the correct indication.