9 Flaws of Mechanical Alignment Total Knee Arthroplasty

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9 Flaws of Mechanical Alignment Total Knee Arthroplasty

By Personalized Arthroplasty Society FEATURING Pascal-André Vendittoli, Marc-Olivier Kiss, Lazaros Kostretzis

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December 1, 2020

Dr Lazaros Kostretzis is an orthopedic surgeon and adult articular reconstruction fellow under the direction ...
read more ↘ of Prof. Pascal-A Vendittoli (Maisonneuve-Rosemont hospital in Montreal, Canada). He is trained to perform kinematic alignment TKA. In the current video, Dr Kostretzis presents the 9 inherent flaws of the “one size fits all” mechanical alignment technique, that has been considered the golden standard for more than 40 years:
1. MA is systematic while patients’ anatomy is variable
2. MA anatomy modifications create compartment imbalances
3. Measured resection MA systematically reduces gaps
4. Medial-lateral and flexion-extension ligament isometry is the goal
5. Systematic femoral external rotation is essential
6. To achieve neutral HKA, ligamentous releases are required
7. Valgus knees have lateral condyle hypoplasia
8. Static HKA is a good representation of the dynamic knee load
9. Deviating from neutral HKA compromises implant long term survivorship
Publications of interest:
-Almaawi AM, Hutt JRB, Masse V, Lavigne M, Vendittoli PA. The Impact of Mechanical and Restricted Kinematic Alignment on Knee Anatomy in Total Knee Arthroplasty. J Arthroplasty. 2017 Jul;32(7):2133-2140. doi: 10.1016/j.arth.2017.02.028.
- Pinskerova V., Vavrik P. (2020) Knee Anatomy and Biomechanics and its Relevance to Knee Replacement. In: Rivière C., Vendittoli PA. (eds) Personalized Hip and Knee Joint Replacement. Springer, Cham. https://doi.org/10.1007/978-3-030-24243-5_14
- Blakeney W, Beaulieu Y, Puliero B, Kiss MO, Vendittoli PA. Bone resection for mechanically aligned total knee arthroplasty creates frequent gap modifications and imbalances. Knee Surg Sports Traumatol Arthrosc. 2020 May;28(5):1532-1541. doi: 10.1007/s00167-019-05562-8. Epub 2019 Jun 14. PMID: 31201441.
For more information, please visit the Personalized Arthroplasty Society web site: http://www.personalizedarthroplasty.com
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