Current Concepts in Alignment in Total Knee Arthroplasty.


Journal

The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515

Informations de publication

Date de publication:
07 2023
Historique:
received: 08 12 2022
revised: 24 01 2023
accepted: 31 01 2023
medline: 23 10 2023
pubmed: 12 2 2023
entrez: 11 2 2023
Statut: ppublish

Résumé

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.

Sections du résumé

BACKGROUND
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.
METHODS
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.
RESULTS
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.
CONCLUSION
Alignment and implant positioning are now at the heart of the debate and surgeons are investigating a more personalized approach to TKA.

Identifiants

pubmed: 36773657
pii: S0883-5403(23)00080-3
doi: 10.1016/j.arth.2023.01.060
pii:
doi:

Types de publication

Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

S29-S37

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Theofilos Karasavvidis (T)

Adult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.

Cale A Pagan Moldenhauer (CA)

Adult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.

Fares S Haddad (FS)

Department of Trauma and Orthopaedic Surgery, University College London Hospital, London.

Michael T Hirschmann (MT)

Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland, Bruderholz, Switzerland.

Mark W Pagnano (MW)

Deparment of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.

Jonathan M Vigdorchik (JM)

Adult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.

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