Kinematically Aligned Total Knee Arthroplasty or Mechanically Aligned Total Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Medical Technology

Background:

• Kinematically aligned total knee arthroplasty (KATKA) aims to restore native knee alignment for physiological kinematics.
• Early results suggest KATKA yields better functional outcomes than mechanically aligned TKA (MATKA).
• Long-term implant survival data for KATKA is limited, but early follow-up shows low tibial component failure rates.

Purpose of the Study:

• To systematically review and meta-analyze existing literature comparing clinical outcomes of KATKA and MATKA.
• To determine if significant clinical differences exist between the two TKA alignment techniques.

Main Methods:

• Systematic review of English-language literature.
• Inclusion of five randomized controlled trials (RCTs) comparing KATKA and MATKA.
• Meta-analysis of extracted data, with some RCTs utilizing patient-specific instrumentation and others navigation.

Main Results:

• KATKA demonstrated statistically significant improvements in WOMAC, OKS, C-KSS, KFS, and postoperative ROM compared to MATKA.
• No significant difference in complication rates requiring reoperation or revision surgery was observed between KATKA and MATKA.
• KATKA showed statistically significant differences in component alignment, including more femoral valgus, tibial varus, and tibial slope.

Conclusions:

• KATKA is associated with superior clinical outcomes and patient-reported scores compared to MATKA.
• KATKA component alignment differs significantly from MATKA, yet does not increase poor clinical results.
• KATKA presents a potential alternative to MATKA, with a negligible risk of tibial loosening revision in the observed follow-up period.