TO PERFORM KA TKA DO I NEED A PRE-OP PLANIFICATION?

NO

Serial verification checks incorporating caliper measurements restores native alignment with high reproducibility

NEDOPIL AJSINGH AKHOWELL SMHULL ML

DOES CALIPERED KINEMATICALLY ALIGNED TKA RESTORE NATIVE LEFT TO RIGHT SYMMETRY OF THE LOWERLIMB AND IMPROVE FUNCTION?

J ARTHROPLASTY. 2018 

DO KA TKA RESTORE BETTER SATISFACTION, FUNCTION AND MOTION THAN MA TKA IN SHORT FOLLOW UP (24 months) ?

YES

6 of 9 Independent RCTs (Randomized Control Trials Studies) from all over the world show KA TKA provides better results than MA TKA

DOSSETT HG, ESTRADA NA, SWARTZ GJ, LEFEVRE GW, KWASMAN BG.

 

A RANDOMISED CONTROLLED TRIAL OF KINEMATICALLY AND MECHANICALLY ALIGNED TOTAL KNEE REPLACEMENTS: TWO-YEAR CLINICAL RESULTS.

 

BONE JOINT J. 2014 

CALLIESS T, BAUER K, STUKENBORG-COLSMAN C, WINDHAGEN H, BUDDE S, ETTINGER M.

PSI KINEMATIC VERSUS NON-PSI MECHANICAL ALIGNMENT IN TOTAL KNEE ARTHROPLASTY: A PROSPECTIVE, RANDOMIZED STUDY.

 

KNEE SURG SPORTS TRAUMATOL ARTHROSC. 2017

MATSUMOTO T, TAKAYAMA K, ISHIDA K, HAYASHI S, HASHIMOTO S, KURODA R.

RADIOLOGICAL AND CLINICAL COMPARISON OF KINEMATICALLY VERSUS MECHANICALLY ALIGNED TOTAL KNEE ARTHROPLASTY.

BONE JOINT J, 2017 

McEWEN PJ, DLASKA CE, JOVANOVIC IA, DOMA K, BRANDON BJ.

COMPUTER-ASSISTED KINEMATIC AND MECHANICAL AXIS TOTAL KNEE ARTHROPLASTY: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL OF BILATERAL SIMULTANEOUS SURGERY.

 

J ARTHROPLASTY. 2019

 

FRENCH SR, MUNIR S, BRIGHTON R.

A SINGLE SURGEON SERIES COMPARING THE OUTCOMES OF A CRUCIATE RETAINING AND MEDIALLY STABILIZED TOTAL KNEE ARTHROPLASTY USING KINEMATIC ALIGNMENT PRINCIPLES. J

 

J ARTHROPLASTY. 2020 

MACDESSI SJ, GRIFFITHS-JONES W, CHEN DB, GRIFFITHS-JONES S, WOOD JA, DIWAN AD, HARRIS IA.

 

RESTORING THE CONSTITUTIONAL ALIGNMENT WITH A RESTRICTIVE KINEMATIC PROTOCOL IMPROVES QUANTITATIVE SOFT-TISSUE BALANCE IN TOTAL KNEE ARTHROPLASTY: A RANDOMIZED CONTROLLED TRIAL.

 

BONE JOINT J. 2020 

DO KA TKA WITH SOME RESTRICTIONS OF PRE-OP DEFORMITY OR POST-OP CORRECTION RESTORE BETTER SATISFACTION, FUNCTION AND MOTION THAN MA TKA IN SHORT FOLLOW UP ?

NO

3 of 9 Independent RCTs (Randomized Control Trials Studies) show KA TKA provides equal results than MA TKA if some restrictions are placed on pre-op deformity and post-op corrections

YOUNG SW, WALKER ML, BAYAN A, ET AL.

 

THE CHITRANJAN S. RANAWAT AWARD: NO DIFFERENCE IN 2-YEAR FUNCTIONAL OUTCOMES USING KINEMATIC VERSUS MECHANICAL ALIGNMENT IN TKA: A RANDOMIZED CONTROLLED CLINICAL TRIAL.

 

CLIN ORTHOP RELAT RES 2016

WATERSON HB, CLEMENT ND, EYRES KS, MANDALIA VI, TOMS AD.

THE EARLY OUTCOME OF KINEMATIC VERSUS MECHANICAL ALIGNMENT IN TOTAL KNEE ARTHROPLASTY: A PROSPECTIVE RANDOMISED CONTROL TRIAL.

 

BONE JOINT J. 2016

 

LAENDE EK, RICHARDSON CG, DUNBAR MJ.

A RANDOMIZED CONTROLLED TRIAL OF TIBIAL COMPONENT MIGRATION WITH KINEMATIC ALIGNMENT USING PATIENT-SPECIFICINSTRUMENTATION VERSUS MECHANICAL ALIGNMENT USING COMPUTER-ASSISTED SURGERY IN TOTAL KNEE ARTHROPLASTY.

BONE JOINT J. 2019 

AT 10-YEAR FOLLOW UP ARE THE ASEPTIC FAILURES MORE FREQUENT WITH KA TKA THAN WITH MA TKA ?

NO

Aseptic survival at 10 years of KA TKA without any restrictions (except incompetence of medial collateral ligament in valgus knees) is 98,5% in comparison of 93% of MA TKA

HOWELL SM, SHELTON TJ, HULL ML.

 

IMPLANT SURVIVAL AND FUNCTION TEN YEARS AFTER KINEMATICALLY ALIGNED TOTAL KNEE ARTHROPLASTY.

 

J ARTHROPLASTY 2018

ABDEL MP, OLLIVIER M, PARRATTE S, TROUSDALE RT, BERRY DJ, PAGNANO MW.

 

EFFECT OF POST-OPERATIVE MECHANICAL AXIS ALIGNMENT ON SURVIVAL AND FUNCTIONAL OUTCOMES OF MODERN TOTAL KNEE ARTHROPLASTIES WITH CEMENT: A CONCISE FOLLOW-UP AT 20 YEARS.

 

J BONE JOINT SURG AM. 2018

ARE THE FAILURES OF KA TKA DUE TO AN EXCESSIVE VARUS PLACING OF THE TIBIAL COMPONENT ?

NO

Tibial component failure is infrequent (0,3%), NEVER due to excessive varus placement, instead due to excessive slope than native. This type of failure is minimized by restoring native slope. Simply look at your cut from lateral!

NEDOPIL AJ, HOWELL SM, HULL ML.

 

WHAT MECHANISMS ARE ASSOCIATED WITH TIBIAL COMPONENT FAILURE AFTER KINEMATICALLY-ALIGNED TOTAL KNEE ARTHROPLASTY?

 

INT ORTHOP. 2017

DO VARUS OR VALGUS OUTLIERS HAVE HIGHER FORCES IN THE MEDIAL OR LATERAL COMPARTMENT THAN THOSE WHICH ARE IN RANGE AFTER KA TKA?

NO

The intra-operative forces in the medial and lateral compartments of patients with outlier alignment were comparable with those with in-range alignment (1).

Furthermore the intra-operative forces are three to six times lower than those reported for MA TKA (2).

(1) SHELTON TJ, NEDOPIL AJ, HOWELL SM, HULL ML

DO VARUS OR VALGUS OUTLIERS HAVE HIGHER FORCES IN THE MEDIAL OR LATERAL COMPARTMENTS THAN THOSE WHICH ARE IN-RANGE AFTER A KINEMATICALLY ALIGNED TOTAL KNEE ARTHROPLASTY? LIMB AND JOINT LINE ALIGNMENT AFTER KINEMATICALLY ALIGNED TOTAL KNEE ARTHROPLASTY

BONE JOINT J. 2017

(2) MENEGHINI RM, ZIEMBA-DAVIS MM, ET AL.

 

CAN INTRAOPERATIVE SENSORS DETERMINE THE “TARGET” LIGAMENT BALANCE? EARLY OUTCOMES IN TOTAL KNEE ARTHROPLASTY

 

J ARTHRO PLASTY 2016

TKA HAVE BEEN DESIGNED FOR MA TKA. DO THEY ALSO WORK WITH KA TKA, EXPECIALLY FOR THE PATELLO-FEMORAL JOINT?

YES

Considering different designs of prosthesis KA technique more closely restores the groove location than MA technique

LOZANO R, CAMPANELLI V, HOWELL S, HULL M.

 

KINEMATIC ALIGNMENT MORE CLOSELY RESTORES THE GROOVE LOCATION AND THE SULCUS ANGLE OF THE NATIVE TROCHLEA THAN MECHANICAL ALIGNMENT: IMPLICATIONS FOR PROSTHETIC DESIGN

 

KNEE SURG SPORTS TRAUMATOL ARTHROSC. 2019

 

RIVIÈRE C, IRANPOUR F, HARRIS S, AUVINET E, AFRAMIAN A, PARRATTE S, COBB J.

DIFFERENCES IN TROCHLEAR PARAMETERS BETWEEN NATIVE AND PROSTHETIC KINEMATICALLY OR MECHANICALLY ALIGNED KNEES.

 

ORTHOP TRAUMATOL SURG RES. 2018

IS PATELLA INSTABILITY AFTER KA TKA A RELEVANT PROBLEM?

NO

Patella instability after KA TKA is infrequent (0.4%) and not due to the design of the TKA related to positioning with a KA technique. Presented atraumatically at 5 months post-op. Patients with PF Instability had 5° more flexion of the femoral component than controls. This type of failure is minimized by restoring the flexion of native DISTAL FEMUR.

 

NEDOPIL AJ, HOWELL SM, HULL ML

 

WHAT CLINICAL CHARACTERISTICS AND RADIOGRAPHIC PARAMETERS ARE ASSOCIATED WITH PATELLOFEMORAL INSTABILITY AFTER KINEMATICALLY ALIGNED TOTAL KNEE ARTHROPLASTY?

 

INT ORTHOP. 2017

 2020 - created by dr. michele malavolta (cod.fis. MLVMHL74A27L781A)