Custom total knee arthroplasty facilitates restoration of constitutional coronal alignment

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
Michel P BonninTarik Aït-Si-Selmi

Abstract

To describe a strategy for coronal alignment using a computed tomography (CT) based custom total knee arthroplasty (TKA) system, and to evaluate the agreement between the planned and postoperative Hip-Knee-Ankle (HKA) angle, Femoral Mechanical Angle (FMA) and Tibial Mechanical Angle (TMA). From a consecutive series of 918 primary TKAs, 266 (29%) knees received CT-based posterior-stabilized cemented custom TKA. In addition to a preoperative CT-scan, pre- and post-operative radiographs of weight-bearing long leg, anterior-posterior and lateral views of the knee were obtained, on which the FMA, TMA and HKA angles were measured. CT-based three-dimensional (3D) models enabled to correct for cases with bony wear by referring to the non-worn areas and to estimate the native pre-arthritic angles. The alignment technique aimed to preserve or restore constitutional alignment (CA) within predetermined limits, by defining a 'target zone' based on three criteria: 1) a ± 3° (range 87°-93°) primary tolerance for the femoral and tibial resections; 2) a ± 2° secondary tolerance for component obliquity, extending the bounds for FMA and TMA (range 85°-95°); 3) a planned HKA angle range of 175°-183°. Agreement between preoperative, planned and pos...Continue Reading

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Citations

Dec 31, 2020·Journal of Clinical Medicine·Cécile BataillerSébastien Lustig
May 28, 2021·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Jeremy DaxheletMichel P Bonnin
Jul 3, 2021·Journal of Personalized Medicine·Céline Saphena MoretMichael Tobias Hirschmann
Jul 15, 2021·Archives of Orthopaedic and Trauma Surgery·Cécile Batailler, Sébastien Parratte
Jul 17, 2021·Archives of Orthopaedic and Trauma Surgery·Céline S MoretMarkus P Arnold
Jul 18, 2021·Archives of Orthopaedic and Trauma Surgery·Jan Victor, Hannes Vermue
Aug 26, 2021·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Jacobus H MüllerGuillaume Demey

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