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Kinematic component alignment in total knee arthroplasty leads to better restoration of natural tibiofemoral kinematics compared to mechanic alignment

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Kinematically aligned total knee arthroplasty is associated with superior pain relief, increased flexion and a more normal feeling knee. It was hypothesized that due to restoring the knee’s natural anatomy, kinematically aligned knees show more physiological tibiofemoral kinematics than mechanically aligned knees.

Methods

Investigations were performed in nine healthy cadaveric knees of whole bodies fixed by the Thiel method. Tibiofemoral kinematics of healthy knees and after kinematically and mechanically aligned total knee arthroplasty were assessed between 0° and 90° of flexion by a navigational device.

Results

Regarding tibial internal rotation or femoral roll back, respectively, kinematically aligned total knee arthroplasties showed no significant differences between 0° and 70° of flexion in comparison to knees before total knee arthroplasty. In contrast, mechanically aligned total knee arthroplasties showed significant changes between 10° and 90° of flexion. Kinematically aligned knees showed a significant changed abduction/adduction between 20° and 70° of flexion, mechanically aligned knees within 20° and 90° of flexion.

Conclusion

In the present study setting kinematically aligned total knee arthroplasties showed more natural and physiological tibiofemoral kinematic pattern with regard to tibial internal rotation or femoral rollback, respectively, and tibial adduction than mechanically aligned total knee arthroplasties. While these results may support promising early clinical results of kinematical alignment proposing a better function, long-term results especially implant survival need to be awaited.

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Acknowledgements

We thank Dr. Martin Bauer, Brainlab, Feldkirchen, Germany, for providing detailed information on the processed data and calculations obtained by means of the navigation software. Furthermore, we would like to thank Prof. Dr. Dr. Friedrich Anderhuber, Institute of Anatomy at the Medical University of Graz/Austria for providing the specimens for this investigation.

Funding

No financial contributions were received for this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Regensburg, Regensburg, Germany

    Günther Maderbacher, Armin Keshmiri, Bernd Krieg, Felix Greimel, Joachim Grifka & Clemens Baier

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  1. Günther Maderbacher
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  2. Armin Keshmiri
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  3. Bernd Krieg
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  4. Felix Greimel
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  5. Joachim Grifka
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  6. Clemens Baier
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Correspondence to Günther Maderbacher.

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Maderbacher, G., Keshmiri, A., Krieg, B. et al. Kinematic component alignment in total knee arthroplasty leads to better restoration of natural tibiofemoral kinematics compared to mechanic alignment. Knee Surg Sports Traumatol Arthrosc 27, 1427–1433 (2019). https://doi.org/10.1007/s00167-018-5105-1

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