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Related Concept Videos

Knee Joint01:23

Knee Joint

2.7K
The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...
2.7K

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Personalized alignment in total knee arthroplasty: current concepts.

Sébastien Lustig1, Elliot Sappey-Marinier2, Camdon Fary3

  • 1Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, 69004 Lyon, France - Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR, LBMC UMR_T9406, 69622 Lyon, France.

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|April 4, 2021
PubMed
Summary
This summary is machine-generated.

Patient-specific alignment in total knee arthroplasty (TKA) moves beyond the traditional neutral alignment. Personalized approaches like kinematic and functional alignment aim to improve knee function and restore natural kinematics.

Keywords:
Functional alignmentImplant survivorshipKinematic alignmentPersonalized alignmentRestricted alignmentTotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Arthroplasty Research

Background:

  • Traditional total knee arthroplasty (TKA) utilized a neutral alignment, but functional outcomes have been inconsistent.
  • Analysis of non-osteoarthritic knees shows natural variations from neutral alignment, challenging the established TKA paradigm.
  • Patient-specific alignment in TKA is emerging as a critical area of investigation.

Purpose of the Study:

  • To review and clarify current personalized alignment techniques in total knee arthroplasty.
  • To report the outcomes associated with these patient-specific alignment strategies.
  • To evaluate the potential of personalized alignment to improve functional results after TKA.

Main Methods:

  • Review of current literature on personalized alignment in TKA.
  • Categorization of personalized alignment approaches: kinematic, inverse kinematic, restricted kinematic, and functional alignment.
  • Description of the principles and techniques for each alignment method, including robotic-assisted approaches for functional alignment.

Main Results:

  • Kinematic alignment aims to restore pre-arthritic anatomy by balancing flexion/extension gaps.
  • Inverse kinematic alignment prioritizes native tibial joint line obliquity with adjustments in femoral resections.
  • Restricted kinematic alignment offers a compromise between mechanical and kinematic alignment within a defined safe zone.
  • Functional alignment leverages advanced technology for patient-specific optimization of alignment, bone morphology, and soft tissues.

Conclusions:

  • Personalized alignment strategies in TKA aim to replicate native knee kinematics for improved functional outcomes.
  • Various personalized alignment techniques (kinematic, inverse kinematic, restricted kinematic, functional) are being explored.
  • Long-term follow-up is essential to validate the outcomes and implant survivorship of these evolving alignment concepts.