Current Concepts in Alignment in Total Knee Arthroplasty
In an effort to increase satisfaction among total knee arthroplasty (TKA) patients, emphasis has been placed on implant positioning and limb alignment. Traditionally, the aim for TKA has been to achieve a neutral mechanical alignment (MA) to maximize implant longevity. However, with the recent spike...
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| Published in: | The Journal of arthroplasty Vol. 38; no. 7; pp. S29 - S37 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Elsevier Inc
01.07.2023
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| ISSN: | 0883-5403, 1532-8406, 1532-8406 |
| Online Access: | Get full text |
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| Abstract | In an effort to increase satisfaction among total knee arthroplasty (TKA) patients, emphasis has been placed on implant positioning and limb alignment. Traditionally, the aim for TKA has been to achieve a neutral mechanical alignment (MA) to maximize implant longevity. However, with the recent spike in interest in individualized alignment techniques and with the advent of new technologies, surgeons are slowly evolving away from classical MA.
This review elucidates the differences in alignment techniques for TKA, describes the concept of knee phenotypes, summarizes comparative studies between MA and individualized alignment, and provides a simple way to incorporate the latter into surgeons’ practice.
In order to manage patients by applying these strategies in day-to-day practice, a basic understanding of the aforementioned concepts is essential. Transition to an individualized alignment technique should be done gradually with caution in a stepwise approach.
Alignment and implant positioning are now at the heart of the debate and surgeons are investigating a more personalized approach to TKA. |
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| AbstractList | In an effort to increase satisfaction among total knee arthroplasty (TKA) patients, emphasis has been placed on implant positioning and limb alignment. Traditionally, the aim for TKA has been to achieve a neutral mechanical alignment (MA) to maximize implant longevity. However, with the recent spike in interest in individualized alignment techniques and with the advent of new technologies, surgeons are slowly evolving away from classical MA.
This review elucidates the differences in alignment techniques for TKA, describes the concept of knee phenotypes, summarizes comparative studies between MA and individualized alignment, and provides a simple way to incorporate the latter into surgeons' practice.
In order to manage patients by applying these strategies in day-to-day practice, a basic understanding of the aforementioned concepts is essential. Transition to an individualized alignment technique should be done gradually with caution in a stepwise approach.
Alignment and implant positioning are now at the heart of the debate and surgeons are investigating a more personalized approach to TKA. In an effort to increase satisfaction among total knee arthroplasty (TKA) patients, emphasis has been placed on implant positioning and limb alignment. Traditionally, the aim for TKA has been to achieve a neutral mechanical alignment (MA) to maximize implant longevity. However, with the recent spike in interest in individualized alignment techniques and with the advent of new technologies, surgeons are slowly evolving away from classical MA.BACKGROUNDIn an effort to increase satisfaction among total knee arthroplasty (TKA) patients, emphasis has been placed on implant positioning and limb alignment. Traditionally, the aim for TKA has been to achieve a neutral mechanical alignment (MA) to maximize implant longevity. However, with the recent spike in interest in individualized alignment techniques and with the advent of new technologies, surgeons are slowly evolving away from classical MA.This review elucidates the differences in alignment techniques for TKA, describes the concept of knee phenotypes, summarizes comparative studies between MA and individualized alignment, and provides a simple way to incorporate the latter into surgeons' practice.METHODSThis review elucidates the differences in alignment techniques for TKA, describes the concept of knee phenotypes, summarizes comparative studies between MA and individualized alignment, and provides a simple way to incorporate the latter into surgeons' practice.In order to manage patients by applying these strategies in day-to-day practice, a basic understanding of the aforementioned concepts is essential. Transition to an individualized alignment technique should be done gradually with caution in a stepwise approach.RESULTSIn order to manage patients by applying these strategies in day-to-day practice, a basic understanding of the aforementioned concepts is essential. Transition to an individualized alignment technique should be done gradually with caution in a stepwise approach.Alignment and implant positioning are now at the heart of the debate and surgeons are investigating a more personalized approach to TKA.CONCLUSIONAlignment and implant positioning are now at the heart of the debate and surgeons are investigating a more personalized approach to TKA. |
| Author | Pagnano, Mark W. Karasavvidis, Theofilos Pagan Moldenhauer, Cale A. Hirschmann, Michael T. Vigdorchik, Jonathan M. Haddad, Fares S. |
| Author_xml | – sequence: 1 givenname: Theofilos orcidid: 0000-0002-6716-2317 surname: Karasavvidis fullname: Karasavvidis, Theofilos organization: Adult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York – sequence: 2 givenname: Cale A. surname: Pagan Moldenhauer fullname: Pagan Moldenhauer, Cale A. organization: Adult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York – sequence: 3 givenname: Fares S. surname: Haddad fullname: Haddad, Fares S. organization: Department of Trauma and Orthopaedic Surgery, University College London Hospital, London – sequence: 4 givenname: Michael T. surname: Hirschmann fullname: Hirschmann, Michael T. organization: Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland, Bruderholz, Switzerland – sequence: 5 givenname: Mark W. surname: Pagnano fullname: Pagnano, Mark W. organization: Deparment of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota – sequence: 6 givenname: Jonathan M. surname: Vigdorchik fullname: Vigdorchik, Jonathan M. organization: Adult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36773657$$D View this record in MEDLINE/PubMed |
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| SubjectTerms | alignment kinematic knee phenotype personalized arthroplasty total knee arthroplasty |
| Title | Current Concepts in Alignment in Total Knee Arthroplasty |
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