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Kinematically Aligned TKA Aligns the Ankle Joint Line Closer to Those of the Native Ankle than Mechanically Aligned TKA in Bipedal Stance

Authors
Kim, JT; Han, J; Lim, S; Shen, QH; Won, YY
Citation
The journal of knee surgery, 32(10). : 1033-1038, 2019
Journal Title
The journal of knee surgery
ISSN
1538-85061938-2480
Abstract
Mechanically aligned total knee arthroplasty (MATKA) aims to make alignment of the hip, knee, and ankle straight unexceptionally. However, emerging evidence suggests that unexceptional straightening the mechanical axis of the lower limb may lead to clinical and radiological problems of the ankle joint. By contrast, kinematically aligned total knee arthroplasty (KATKA) strives to restore the articular surface of the prearthritic knee. In this study, we examined results from KATKA and MATKA to determine which surgery restores the ankle joint orientation closer to the native ankle joint in bipedal stance and hypothesized that KATKA, rather than MATKA, would be more effective. Data from long-leg standing radiographs of 60 healthy adults (control group, n = 120 knees), patients who underwent MATKA (n = 90 knees), and patients who underwent KATKA (n = 90 knees) were retrospectively reviewed. The hip-knee-ankle angle, orientation of the tibial plafond and the talar dome relative to the ground (G-plafond and G-talus, respectively), and orientation of the plafond relative to the mechanical axis of the limb (M-plafond and M-talus, respectively) were measured and analyzed for comparison. Results show that bipedal stance alignment in patients who underwent KATKA (G-plafond: -0.65 +/- 3.03 and G-talus: -1.72 +/- 4.02) were not significantly different to native ankle joint alignment indicated by the control group. Compared with the native ankle joint measured in the control group (G-plafond: -0.76 +/- 2.69 and G-talus: -1.30 +/- 3.25), the tibial plafond and talar dome significantly tilted laterally relative to the ground in ankle joints after MATKA (G-plafond: -2.32 +/- 3.30 and G-talus: -2.97 +/- 3.98, p = 0.001 and p = 0.004, respectively). Thus, postoperative ankle joint line orientation after KATKA was horizontal to the floor and closer to that of native ankle joints than those after MATKA. The level of evidence is Level III.
MeSH terms
AdultAgedAnkle Joint / diagnostic imaging*Ankle Joint / physiopathologyAnkle Joint / surgeryArthroplasty, Replacement, Knee / adverse effectsArthroplasty, Replacement, Knee / methods*Biomechanical PhenomenaBone Malalignment / diagnostic imagingBone Malalignment / etiologyBone Malalignment / prevention & control*Bone Malalignment / surgeryFemaleGenu Varum / diagnostic imagingGenu Varum / etiologyGenu Varum / physiopathologyGenu Varum / surgeryHumansKnee Joint / physiopathologyKnee Joint / surgery*Knee ProsthesisLower Extremity / diagnostic imaging*Lower Extremity / physiopathologyLower Extremity / surgeryMaleMiddle AgedOsteoarthritis, Knee / complicationsOsteoarthritis, Knee / diagnostic imagingOsteoarthritis, Knee / physiopathology*Osteoarthritis, Knee / surgeryRetrospective StudiesStanding PositionYoung Adult
DOI
10.1055/s-0039-1694796
PMID
31434142
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Orthopedic Surgery
AJOU Authors
김, 정택원, 예연
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