Current evidence base for kinematic alignment

Aktuelle Evidenzbasis für kinematisches Alignment

Abstract

Background

Kinematic alignment recently became an alternative alignment option for total knee arthroplasty (TKA). Beside previous studies assessing mechanical alignment in comparison to unintentional malalignment of TKA in terms of implant survival and clinical outcome, more and more studies have focused on the direct comparison of intentional kinematic alignment with mechanical alignment of the prosthesis. In the past 5 years the number of studies with respect to kinematic alignment has risen from 11 to 91 studies.

Aim

The aim of this review article is to give a narrative overview of the current literature in the debate concerning kinematic and mechanical alignment in TKA.

Zusammenfassung

Hintergrund

Das kinematische Alignment hat sich in den letzten Jahren zu einer etablierten Methode in der Knieendoprothetik entwickelt. Neben früheren Studien, welche die mechanische Ausrichtung im Vergleich zur unbeabsichtigten Fehlpositionierung der Knieendoprothese (Varus- und Valgusfehlstellung) im Hinblick auf das Implantatüberleben und das klinische Ergebnis untersuchten, konzentrieren sich immer mehr Studien auf den direkten Vergleich der kinematischen und mechanischen Prothesenausrichtung. In den letzten 5 Jahren ist die Anzahl der Studien zum kinematischen Alignment von rund 11 auf 91 Studien gestiegen.

Ziel

Das Ziel dieses Beitrags ist es, einen Überblick über die aktuelle Literaturlage hinsichtlich des kinematischen im Vergleich zum mechanischen Alignment in der Knietotalendoprothetik zu geben.

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Abbreviations

AP:

Anteroposterior

CTF:

Coronal tibiofemoral angle

FE:

Finite element

HKA:

Hip-to-Knee-Angle

ICPD:

Intercompartmental pressure difference

KA:

Kinematic alignment

KAM:

Knee adduction moment

MA:

Mechanical alignment

MCL:

Medial collateral ligament

PCA:

Posterior condylar axis

PE:

Polyethylene

RCT:

Randomized controlled trial

RSA:

Radiostereometric analysis

TEA:

Transepicondylar axis

TFA:

Tibiofemoral angle

TKA:

Total knee arthroplasty

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Correspondence to L.-R. Tuecking.

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L.-R. Tuecking, P. Savov, H. Windhagen and M. Ettinger declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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Tuecking, L., Savov, P., Windhagen, H. et al. Current evidence base for kinematic alignment. Orthopäde 49, 584–592 (2020). https://doi.org/10.1007/s00132-020-03932-6

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Keywords

  • Total knee arthroplasty
  • Mechanical alignment
  • Alternative alignment
  • Implant survival
  • Review

Schlüsselwörter

  • Knietotalendoprothethik
  • Mechanisches Alignment
  • Alternatives Alignment
  • Implantatüberleben
  • Review