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Alignment for total knee replacement: a comparison of kinematic axis versus mechanical axis techniques. A cadaver study

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Abstract

Purpose

Standard instrumentation tries to reproduce mechanical axes based on mechanical alignment (MA) guides. A kinematic alignment (KA) technique derives its plan from pre-operative MRI-measurements. This matched-pair cadaveric study compared the resulting postoperative alignments.

Methods

A prospective series of 12 torsos were acquired for a total of 24 limb specimens including intact pelvises, femoral heads, knees, and ankles.The cadavers received MRI scans to manufacture the kinematic alignment cutting guides. Two investigating surgeons performed total knee arthroplasties on randomly chosen sides using MA instruments. On the contralateral sides, KA cutting guides were used. A navigation system was used to measure final alignment.

Results

The overall alignment showed no significant differences between the systems. In the MA group the differences between the planned and the final implantation regarding overall limb alignment ranged between 0.2° and 6.2°. In the KA group the differences between the planned and final implantation regarding overall limb alignment ranged between 0.3° and 9.1°. The differences of the deviation from plan for overall limb alignment showed no significant differences between the methods.

Conclusions

The different alignment strategies resulted in variations of the combinations of the three-dimensional component position on the femur and the tibia. However, the legs were aligned within comparable range for both chosen techniques.

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Acknowledgements

We would like to thank Mag. Dennis Huber for his help with the study design and statistics.

Conflict of interest

This study was funded by Stryker Corp. While Stryker provide the materials and funding, the company did not plan the experiment, interpret the data or write the manuscript.

William Hozack, Dermot Collopy, Eckart Mayr, and Michael Nogler are paid consultants for Stryker Corp.

Eckart Mayr and Michael Nogler are presentation speakers for Stryker Corp.

Michael Nogler receives research support from Stryker Corp.

William Hozack receives royalties from Stryker Corp.

No further conflicts of interest to declare.

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Correspondence to Michael Nogler.

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Nogler, M., Hozack, W., Collopy, D. et al. Alignment for total knee replacement: a comparison of kinematic axis versus mechanical axis techniques. A cadaver study. International Orthopaedics (SICOT) 36, 2249–2253 (2012). https://doi.org/10.1007/s00264-012-1642-2

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  • DOI: https://doi.org/10.1007/s00264-012-1642-2

Keywords

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