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Published on: January 24, 2018
Comparative outcomes of kinematically aligned TKA with medial stabilized design vs. mechanically aligned TKA with
Ryota Fujii1,2, Tsuneari Takahashi3, Masaki Iguchi4
1Department of Orthopedic Surgery, Kobari General Hospital, Noda, Japan.
Purpose:
Patient dissatisfaction after total knee arthroplasty (TKA) is often linked to altered knee kinematics and stability. This study compared the short-term clinical outcomes of kinematically aligned TKA (KA-TKA) and mechanically aligned TKA (MA-TKA) using bi-cruciate stabilized (BCS) implants.
Methods:
In this propensity score-matched study, 60 patients who underwent either KA-TKA or MA-TKA (30 per group) with BCS implants were analyzed. Baseline characteristics, including age, sex, preoperative range of motion (ROM), and hip-knee-ankle alignment, were matched. ROM and clinical outcomes were evaluated preoperatively and at 1 year postoperatively using the 2011 Knee Society Score (KSS) subscales and Forgotten Joint Score-12 (FJS).
Results:
At 1 year, the KA group achieved higher scores in KSS subscales for symptoms (23.2 vs. 20.0, p < 0.001), satisfaction (28.1 vs. 22.5, p < 0.001), functional activities (82.1 vs. 74.2, p = 0.011), and FJS (83.8 vs. 62.5, p < 0.001). No significant differences were observed in maximum extension, flexion, or KSS expectations.
Conclusions:
KA-TKA demonstrated superior satisfaction and functional recovery than MA-TKA with BCS implants in the short term. These results suggested that KA-TKA, which reconstructs patient-specific alignment, may provide a more natural knee feel, leading to higher patient satisfaction compared to implant-driven BCS-TKA.
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