The relationship between constitutional alignment and varus osteoarthritis of the knee

Vandekerckhove, Pieter-Jan; Matlovich, Nicholas F.; Teeter, Matthew G.; MacDonald, Steven J.; Howard, James L.; Lanting, Brent A.

doi:10.1007/s00167-016-3994-4

Cited by 41 publications

(49 citation statements)

References 39 publications

(48 reference statements)

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“…Conversely, in a population of symptomatic osteoarthritic patients, 71% had varus alignment with a mean HKA of -9.0° [8]. Vandekerckhove et al [9], have shown that constitutional varus does contribute to a higher incidence of osteoarthritis in the general population. Coronal alignment is considered an important variable in attaining a well-functioning TKA [10][11][12].…”

Section: Discussionmentioning

confidence: 96%

Clinical Evaluation of the Mechanical Axis Finder (MAF) by Radiologic Scanogram of 100 Consecutive Axis Total Knee Replacements

Gustilo¹

2020

OPROJ

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The use of Mechanical Axis Finder (MAF) is reliable in achieving the correct mechanical axis in (93.3%) out of 100 consecutive Axis Knee System Surgeries. Correct mechanical Axis is defined as 0 degrees(neutral) + -3 degrees. The rest (6.7%) fell 4-7 degrees of varus or 8-9 degrees valgus. Post-operative scanograms (hip-knee-ankle) were obtained in all 100 knees, 2-3 months after surgery. Patello-femoral tracking based on patella lateral displacements on Laurin patellar x-ray view, eighty nine percent exhibited normal or minimal lateral displacement. There was no patellar dislocation. All bone preparations of both femur and tibia were performed using extramedullary method. The preoperative knee society pain score improved from 49.59 to 88.95 at 2-3 months follow up. The patient satisfaction rate, average score was 87.8%. Complications consisted of 2 infection, 2 aseptic femoral loosening requiring revision and two knee stiffness. With the use of the Axis Knee System, the cost of TKA in the Philippines is markedly reduced by 100-200%.

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Section: Discussionmentioning

confidence: 96%

Clinical Evaluation of the Mechanical Axis Finder (MAF) by Radiologic Scanogram of 100 Consecutive Axis Total Knee Replacements

Gustilo¹

2020

OPROJ

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“…Native knee alignment varies throughout the tion of symptomatic osteoarthritic patients, 71% had varus alignment with a mean HKA of -9.0°. [30] Additionally, Vandekerckhove et al [52], have shown that constitutional varus does contribute to a higher incidence of osteoarthritis in the general population.…”

Section: The Importance Of Coronal Alignment In Total Knee Arthroplastymentioning

confidence: 99%

Coronal Alignment in TKA: Traditional Principles Versus New Concepts

Parisi¹,

Dennis²

2018

ReconRev

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Background: Up to 20% of total knee arthroplasty (TKA) patients are not satisfied with their outcome, and coronal alignment is considered an important variable in attaining a well-functioning TKA. Neutral mechanical alignment is not necessarily the anatomic norm and has led some surgeons to advocate a shift in defining and attaining the optimal coronal component alignment. Our aim was to review the different coronal alignment paradigms of TKA and summarize the historical and contemporary outcomes of different alignment techniques.Methods: A systematic review was performed in March 2017 via PubMed using the search terms: coronal alignment, kinematic alignment, and total knee replacement using Boolean “and” in-between terms. Relevant results were then reviewed, analyzed and summarized Conclusions: Early clinical outcomes of kinematically aligned TKAs are promising, but long-term clinical results are unknown. Clinical, laboratory, and retrieval studies suggest that mechanical varus in TKA, especially involving the tibial component, may result in earlier failure. Kinematic alignment with boundaries may be an optimal strategy for patients with pre-operative constitutional varus or congenital tibia vara.

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“…There are studies showing that when the deviation of the alignment angle between the mechanical axis and the prosthetic component is controlled within 3˚, knee function and prosthesis life is improved [6,38,39]. Before assessing the differences in long-term follow-up results for computer-assisted TKA and conventional TKA, it is necessary to evaluate whether there are individual differences between the two techniques in terms of knee force lines, prosthetic accuracy, and degree of matching.…”

Section: Plos Onementioning

confidence: 99%

“…The precise matching of the prosthetic component is closely related to the clinical effect in total knee arthroplasty (TKA) [ 1 – 3 ]. The ideal prosthetic implantation restores the mechanical axis of the lower extremity to the range of 0° ± 3° [ 1 , 4 – 6 ]. Computer-assisted TKA has recently made remarkable developments in clinical application.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the clinical effects of computer-assisted and traditional techniques in bilateral total knee arthroplasty: A meta-analysis of randomized controlled trials

Zhao

Shan

et al. 2020

PLoS ONE

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Background It is unclear whether there are individual differences in the long-term efficacy of computerassisted and traditional total knee arthroplasty. The purpose of this study was to perform a meta-analysis comparing the same individuals undergoing computer-assisted and traditional total knee arthroplasty separately to determine whether computer-assisted total knee arthroplasty can provide better lower extremity radiographic results and clinical outcomes. Methods We searched literatures to identify relevant randomized controlled trials comparing the effects of computer-assisted and traditional methods in bilateral total knee arthroplasty. After screening, quality evaluation and data extraction according to inclusion and exclusion criteria, the quality and bias risks of the included studies were evaluated. The meta-analysis compared the radiographic results, functional outcomes and complications of the two techniques. Results Six clinical controlled trials were included, with total of 1098 patients. The meta-analysis showed that the accuracy in terms of the mechanical axis of the lower extremity, the sagittal alignment of the femoral component and the coronal alignment of the tibial component in computer-assisted total knee arthroplasty was significantly better than those in traditional total knee arthroplasty. There were no differences in the functional results, revision rates or aseptic loosening rates between the two techniques. Conclusion After excluding individual differences such as bone development and bone quality, although computer-assisted techniques can better accurately correct the mechanical axis of the lower extremity and the position of prosthesis implantation than traditional techniques, there

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The relationship between constitutional alignment and varus osteoarthritis of the knee

Abstract: III.

Cited by 41 publications

References 39 publications

Clinical Evaluation of the Mechanical Axis Finder (MAF) by Radiologic Scanogram of 100 Consecutive Axis Total Knee Replacements

Clinical Evaluation of the Mechanical Axis Finder (MAF) by Radiologic Scanogram of 100 Consecutive Axis Total Knee Replacements

Coronal Alignment in TKA: Traditional Principles Versus New Concepts

Comparison of the clinical effects of computer-assisted and traditional techniques in bilateral total knee arthroplasty: A meta-analysis of randomized controlled trials

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