Comparison between arithmetic, osteoarthritic and prosthetic HKA: a cohort of computer assisted unrestricted kinematically aligned TKA patients - 09/06/26
, Loic Villet b, c, Charles Rivière b, cAbstract |
Introduction |
Kinematic alignment (KA) in total knee arthroplasty (TKA) aims to restore native knee anatomy and limb alignment. Accurate estimation of constitutional alignment is therefore essential. This study evaluated whether different Computer-Assisted Surgery (CAS)-derived hip-knee-ankle (HKA) measurements predict prosthetic alignment (pHKA).
Methods |
A total of 206 consecutive patients undergoing unrestricted KA-TKA were included. Osteoarthritic HKA (oaHKA), stressed osteoarthritic HKA (s-oaHKA), and prosthetic HKA (pHKA) were measured intra-operatively using CAS. Arithmetic HKA (aHKA) was calculated as MPTA–LDFA.
Results |
Mean pHKA was 0.52° varus (SD 2.56°). Strong correlations were found between pHKA and both s-oaHKA (r = 0.70) and aHKA (r = 0.76), whereas correlation with oaHKA was negligible (r = 0.06). The mean difference between pHKA and aHKA was 1.13°, compared to 1.7° for s-oaHKA. Only 2% of knees showed a difference ≥5° between aHKA and pHKA, compared to 8.2% for s-oaHKA.
Conclusion |
CAS-derived aHKA is a reliable predictor of prosthetic alignment and outperforms stress testing. Unrestricted KA-TKA resulted in extreme alignment (>5°) in only a small proportion of cases (4%).
Level of evidence |
IV; retrospective observational study.
Le texte complet de cet article est disponible en PDF.Keywords : Total knee replacement, Kinematics, Computer assisted surgery, Ultra-congruent / mobile bearing / cemented total knee prosthesis design (E-motion®), Lower-limb alignment categories (varus, neutral, valgus), Computational navigation system (Orthopilot®)
Plan
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