Boundaries in Kinematic Alignment: Why, When, and How

Pier Francesco Indelli; Giuseppe Petralia; Stefano Ghirardelli; Pieralberto Valpiana; Giuseppe Aloisi; Andrea Giordano Salvi; Salvatore Risitano

doi:10.1055/a-2395-6935

The Journal of Knee Surgery, Inhaltsverzeichnis

J Knee Surg 2025; 38(07): 324-327
DOI: 10.1055/a-2395-6935

Special Focus Section

Boundaries in Kinematic Alignment: Why, When, and How

Autor*innen

Pier Francesco Indelli

¹Department of Orthopaedic Surgery, Südtiroler Sanitätsbetrieb, Brixen, Italy

²Paracelsus Medical University (PMU), Institute of Biomechanics, Paracelsus Medical University, Salzburg, Austria

³CESAT, Azienda Sanitaria Toscana Centro, Fucecchio, Italy

⁴Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, California
Giuseppe Petralia

⁵Dipartimento di Medicina Clinica, Sanita' Pubblica, Scienze della Vita e dell'Ambiente, Universita' degli Studi dell'Aquila, L'Aquila, Italy
Stefano Ghirardelli

¹Department of Orthopaedic Surgery, Südtiroler Sanitätsbetrieb, Brixen, Italy

²Paracelsus Medical University (PMU), Institute of Biomechanics, Paracelsus Medical University, Salzburg, Austria
Pieralberto Valpiana

¹Department of Orthopaedic Surgery, Südtiroler Sanitätsbetrieb, Brixen, Italy

²Paracelsus Medical University (PMU), Institute of Biomechanics, Paracelsus Medical University, Salzburg, Austria
Giuseppe Aloisi

⁵Dipartimento di Medicina Clinica, Sanita' Pubblica, Scienze della Vita e dell'Ambiente, Universita' degli Studi dell'Aquila, L'Aquila, Italy
Andrea Giordano Salvi

¹Department of Orthopaedic Surgery, Südtiroler Sanitätsbetrieb, Brixen, Italy
Salvatore Risitano

²Paracelsus Medical University (PMU), Institute of Biomechanics, Paracelsus Medical University, Salzburg, Austria

⁶Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy

Abstract

The use of alternative alignments in total knee arthroplasty (TKA) has recently been increasing in popularity: many of these alignments have been included in the broad spectrum of “kinematic alignment.” This alternative approach was recommended to increase patients' satisfaction since many studies based on patient-reported outcome measures (PROMs) showed that every fifth patient is not satisfied with the surgical outcome. In fact, the original kinematic alignment technique was designed as a “pure resurfacing” technique, maintaining the preoperative axes (flexion–extension and axial rotation) of the knee. In adjunct, many new classifications of the preoperative limb deformity have been proposed to include a large range of knee anatomies, few of them very atypical. Following those classifications, many surgeons aimed for a reproduction of unusual anatomies putting in jeopardy the survivorship of the implant according to the classical “dogma” of a poor knee kinematics and TKA biomechanics if the final hip–knee–ankle (HKA) axis was not kept within 5 degrees from neutral. This article reviews the literature supporting the choice of setting alignment boundaries in TKA when surgeons are interested in reproducing the constitutional knee anatomy of the patient within a safe range.

Keywords

boundaries - alignment - kinematic alignment - TKA - arthroplasty - phenotypes

Volltext

Referenzen

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