Predictors of Lower Limb Coronal Malalignment after Conventional Total Knee Arthroplasty Using a Mechanical Alignment...

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Medical Imaging Analysis

Background:

• Total knee arthroplasty (TKA) aims to restore neutral lower limb alignment.
• Coronal malalignment (CM) is a potential complication following TKA.
• Risk factors for post-TKA CM have not been extensively studied.

Purpose of the Study:

• To determine the incidence of coronal malalignment (CM) after conventional total knee arthroplasty (TKA).
• To identify preoperative risk factors associated with post-TKA CM.

Main Methods:

• Retrospective review of 402 conventional primary TKAs.
• Data extracted included demographics, bone alignment parameters, and joint angles.
• Multiple logistic regression analysis was used to identify risk factors for CM.

Main Results:

• The incidence of post-TKA CM was 42.79% (172 out of 402 knees).
• Significant risk factors for CM included: flexion contracture > 10°, femoral bowing > 4.9°, tibial bowing > 2.2°, preoperative MPTA ≤ 85°, preoperative HKAA ≥ 20° varus, preoperative JLCA 4°-10°, and CCD ≤ 131°.
• These associations remained significant after excluding extreme outliers.

Conclusions:

• Preoperative identification of risk factors can predict the likelihood of CM after TKA.
• A patient with three or more risk factors has a 40.5% risk of CM.
• Awareness of these factors allows surgeons to enhance precision during TKA procedures.