No difference in outcomes and gait analysis between mechanical and kinematic knee alignment methods using robotic total knee arthroplasty
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The purpose of this study was to compare clinical outcomes and perform gait analysis during walking to identify differences in kinematic and kinetic parameters between two alignment methods in robotic-assisted total knee arthroplasty (TKA).
Sixty patients were randomly assigned to undergo robotic-assisted TKA using either mechanical (30 patients) or kinematic (30 patients) alignment method. Clinical outcomes including varus and valgus laxities, range of motion (ROM), Hospital for Specific Surgery (HSS), Knee Society Score (KSS), and Western Ontario and McMaster Universities (WOMAC) scores and radiological outcomes were evaluated. Gait analysis of 3D spatiotemporal, kinetic, and kinematic parameters during walking was then performed for 10 age and gender matched patients of each group to determine differences between the two alignment methods.
The median follow-up duration of the mechanical method group was 8.7 (range 8.1–9.4) years and that of the kinematic method group was 8.4 (range 8.0–9.1) years. Clinical outcomes between the two groups showed no significant difference in HSS, WOMAC, ROM, KS pain, or function score at the last follow-up. No significant difference in varus and valgus laxity assessment, mechanical alignment of the lower limb, or perioperative complications was shown between the two groups. In gait analysis, no significant difference in kinematic or kinetic parameters was found except for varus angle (p < 0.05) and mediolateral ground reaction force (p < 0.05).
Results of this study show that mechanical and kinematic knee alignment methods provide comparable clinical and radiological outcomes after robotic total knee arthroplasty with an average follow-up of 8 years. There were no functional difference during walking between the two alignment methods either.
Level of evidence
KeywordsMechanical alignment Kinematic alignment Total knee arthroplasty
No specific grant was received for this research from funding agencies in the public, commercial, or not-for-profit-sectors.
No funding related with this study.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Institutional Review Board of Chonnam National University Hospital approved this study.
Written informed consent for participation in the study was obtained from all patients, including permission to access patient’s records and publish individual clinical details.
- 1.Bargren JH, Blaha JD, Freeman MAR (1983) Alignment in total knee arthroplasty: correlated biomechanical and clinical observations. Clin Orthop Relat Res 173:178–183Google Scholar
- 4.Dorr LD, Boiardo RA (1986) Technical considerations in total knee arthroplasty. Clin Orthop Relat Res 205:5–11Google Scholar
- 5.Dossett HG, Swartz GJ, Estrada NA, LeFevre GW, Kwasman BG (2012) Kinematically versus mechanically aligned total knee arthroplasty. Orthopedics 35:160–169Google Scholar
- 8.Hungerford DS, Kenna RV, Krackow KA (1982) The porous coated anatomic total knee. Orthop Clin N Am 13:103–122Google Scholar
- 10.Insall JN, Binazzi R, Soudry M, Mestriner LA (1985) Total knee arthroplasty. Clin Orthop Relat Res 192:13–22Google Scholar
- 11.Insall J. Tria AJ, Scott WN (1979) The total condylar knee prosthesis: the first 5 years. Clin Orthop Relat Res 145:68–77Google Scholar
- 18.Moreland JR (1988) Mechanisms of failure of total knee arthroplasty. Clin Orthop Relat Res 226:49–64Google Scholar