Alignment Philosophies in Total Knee Arthroplasty: A Comprehensive Narrative Review

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Medical Technology

Background:

• Traditional total knee arthroplasty (TKA) aims for neutral mechanical alignment, but only 50% of patients achieve this.
• Despite technological advancements in TKA implants and techniques, 20% of patients report long-term dissatisfaction.

Purpose of the Study:

• To compare outcomes of different alignment philosophies in TKA.
• To review the effectiveness of computer-assisted and robotic-assisted TKA.
• To evaluate the role of sensors and tensioners in TKA alignment and explore future developments.

Main Methods:

• Literature review of current alignment philosophies in TKA.
• Analysis of outcomes from computer-assisted navigation and robotic-assisted TKA.
• Evaluation of sensor and tensioner roles in TKA alignment.

Main Results:

• The review synthesizes existing literature on TKA alignment outcomes.
• It highlights the persistent challenge of achieving optimal alignment and patient satisfaction.
• Current data suggests a need for improved alignment strategies in TKA.

Conclusions:

• Current alignment philosophies and technologies in TKA have limitations in achieving consistent neutral alignment and patient satisfaction.
• Further research and development are needed to improve TKA outcomes.
• The review identifies potential future directions for TKA alignment and technology.