Current opinions about coronal plane alignment in total knee arthroplasty: A survey article

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Radiology

Background:

• Coronal knee alignment is crucial for total knee arthroplasty (TKA) outcomes.
• Defining optimal alignment goals remains an area of ongoing discussion among surgeons.

Purpose of the Study:

• To survey international knee surgeons on their current practices and objectives for coronal alignment in TKA.
• To understand surgeon preferences regarding preoperative and postoperative alignment parameters.

Main Methods:

• A global survey of 300 knee surgeons across 32 countries.
• Utilized an audience response system for data collection on alignment preferences.

Main Results:

• Surgeons rarely use full leg radiographs, preferring short films for assessment.
• A trend towards neutral mechanical alignment was observed, with acceptance of residual varus (via femoral cuts) in specific cases.
• Postoperative goals include a joint line parallel to the floor and a central load-bearing axis.

Conclusions:

• Neutral alignment, a parallel joint line, and a central load axis are primary goals for TKA surgeons.
• The orthopedic community is increasingly accepting of minor outliers in alignment due to existing literature.