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Kinematic Alignment Technique Outperforms Mechanical Alignment in Simultaneous Bilateral Total Knee Arthroplasty: A
Mohammad Mahdi Sarzaeem1, Mohammad Movahedinia2, Alireza Mirahmadi2
1Department of Orthopedic Surgery and Traumatology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
The Journal of Arthroplasty
|March 27, 2024
Summary
Kinematic alignment (KA) in total knee arthroplasty showed improved outcomes over mechanical alignment (MA). KA resulted in shorter surgery times, faster recovery, and greater patient satisfaction at two years.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Clinical Trials
Background:
- Bilateral knee osteoarthritis necessitates effective surgical interventions.
- Total knee arthroplasty (TKA) aims to restore function and alleviate pain.
- Comparing alignment techniques is crucial for optimizing TKA outcomes.
Purpose of the Study:
- To compare clinical outcomes of kinematic alignment (KA) versus mechanical alignment (MA) in single-stage bilateral total knee arthroplasty.
- To evaluate patient satisfaction and functional recovery following KA and MA TKA.
- To assess radiographic parameters after KA and MA TKA.
Main Methods:
- A double-blinded randomized controlled trial involving 65 patients with bilateral knee osteoarthritis.
- Simultaneous bilateral TKA with one knee randomized to calipered-KA and the other to MA.
- Assessment using Oxford Knee Score, WOMAC, VAS, Forgotten Joint Score, and range of motion at 2 years postoperatively.
Main Results:
- Kinematic alignment (KA) demonstrated significant improvements in surgery duration, recovery time, WOMAC scores, Forgotten Joint Score, and maximum flexion compared to mechanical alignment (MA) (P < .05).
- No significant differences were observed in VAS or Oxford Knee Score between KA and MA.
- The KA knee was preferred by most patients, with no prosthetic failures or revisions reported in either group.
Conclusions:
- Kinematic alignment (KA) offers acceptable functional outcomes and higher patient satisfaction compared to mechanical alignment (MA) in bilateral total knee arthroplasty.
- KA is associated with reduced surgery time and accelerated recovery.
- Further multicenter studies with extended follow-up are recommended to validate these findings.
