The current role of coronal plane alignment in Total Knee Arthroplasty in a preoperative varus aligned population: an evidence based review

Based on historical data, the current standard of care in Total Knee Arthroplasty (TKA) is to restore the overall alignment to a neutral mechanical axis of 0°±3° or even slight valgus. However, there is significant controversy in literature regarding intentionally placing the TKA in the patient'...

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Bibliographic Details
Published in:Acta orthopaedica belgica Vol. 82; no. 1; p. 129
Main Authors: Vandekerckhove, Pieter-Jan, Lanting, Brent, Bellemans, Johan, Victor, Jan, MacDonald, Steven
Format: Journal Article
Language:English
Published: Belgium 01.03.2016
Subjects:
Arthroplasty, Replacement, Knee - methods
Bone Malalignment - etiology
Bone Malalignment - surgery
Humans
Osteoarthritis, Knee - complications
Osteoarthritis, Knee - surgery
ISSN:0001-6462
Online Access:Get more information
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Summary:Based on historical data, the current standard of care in Total Knee Arthroplasty (TKA) is to restore the overall alignment to a neutral mechanical axis of 0°±3° or even slight valgus. However, there is significant controversy in literature regarding intentionally placing the TKA in the patient's physiologic, rather than neutral (0±3°), mechanical alignment. The goal of this review is to provide a concise update on the present knowledge of coronal plane alignment TKA in a varus population. A systematic overview of the present literature was undertaken to determine basic science and clinical results in frontal plane alignment in primary TKA. Results of studies based on laboratory research, retrieval analysis, cadaver research, finite models, survival scores, clinical outcome, gait analysis and radiographic outcome upon today are provided. Currently placement of a TKA in neutral alignment of 0°±3° of frontal plane alignment is the standard of care. However, frontal plane alignment in neutral may not be as strongly correlated to survivorship as previously thought. Caution needs to be exercised before changing the standard of care, and more research needs to be performed.
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ISSN:0001-6462