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Updated: Feb 8, 2026

Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Alignment in total knee arthroplasty - A comparison of patient-specific implants with the conventional technique
Dariusch Arbab1, Pia Reimann2, Martin Brucker3
1Department of Orthopedic Surgery, Klinikum Dortmund, Member Faculty of Health Witten/Herdecke University, Beurhausstraße 40, 44137 Dortmund, Germany.
Background:
Incorrect positioning and malalignment of total knee arthroplasty (TKA) components can result in implant loosening. Restoration of neutral alignment of the leg is an important factor affecting the long-term results of TKA. The aim of our retrospective study was to compare mechanical axis in patients with conventional and patient-specific TKAs.
Methods:
232 patients who underwent TKA between January 2013 and December 2014 were included to compare postoperative mechanical axis. 125 patients received a patient-specific TKA (iTotal CR®, Conformis) and 107 a conventional TKA (Triathlon®, Stryker). Standardized pre- and postoperative long-leg standing radiographs were retrospectively evaluated to compare the two patient cohorts.
Results:
113 (90%) radiographs of patient-specific TKA and 88 (82%) of conventional TKA were available for comparison. The preoperative deviation from neutral limb axis was 9.0° (0.1–27.3°) in the patient-specific TKA cohort and 8.2° (0.2–18.2°) in the conventional TKA group. Postoperatively the patient-specific TKA group showed 3.2° (0.1–8.4°) and the conventional TKA cohort 2.3° (0.1–12.5°) deviation. However, the rate of ± 3° outliers from neutral limb axis was 16% in the patient-specific TKA cohort and 26% in the conventional TKA group.
Conclusions:
Patient-specific TKA demonstrated fewer outliers from neutral leg alignment compared to conventional technique. Potential benefits in the long-term outcome and functional improvement require further investigation.
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