Comparison of early clinical outcomes of kinematic and mechanical alignments in total knee arthroplasty

doi:10.3877/cma.j.issn.1674-134X.2021.02.006

Abstract

Abstract:

Objective

To explore the difference and early clinical results of kinematic alignment (KA) and mechanical alignment (MA) total knee arthroplasty (TKA) with conventional instruments.

Methods

A retrospective analysis of patients undergoing TKAs at Beijing Chaoyang Hospital, Capital Medical University from April 2020 to July 2020 due to knee osteoarthritis.Patients with a history of lower extremity fractures and severe deformities of the lower extremities were excluded, including six males and 30 females, with an average age of (68.4±6.0)years. There were 17 cases in the KA-TKA group and 19 cases in the MA-TKA group. The time of the surgical procedure, the value of hemoglobin (Hb) on the third day after the surgery, the active rang of motion (AROM) on the fifth day after the surgery, the hip-knee-ankle angle (HKA) three months after surgery, the knee joint clinical score(KS-C) and the knee joint functional score (KS-F) three months after the surgery in both groups, were recorded and analyzed statistically. The data of the same group before and after the surgery were analyzed by paired t test, and the data between the two groups was analyzed by independent t test.

Results

The surgical procedure durations of the KA-TKA and MA-TKA groups were (76.9±11.8) and (78.3±12.7) min, respectively, and the difference was not statistically significant(t=0.35, P>0.05). The HKA of the two groups after the surgery were (2.7±1.2) and (2.1±1.5) respectively, and the difference was not statistically significant (t=1.60, P>0.05). The Hb values of the two groups on the third day after the surgery were (113.3±9.1) and (111.3±8.2) g/L, respectively, and the difference was not statistically significant(t=0.70, P>0.05). The AROM values of the two groups on the fifth day after the surgery were (105.6±8.3) ° and (95.4±14.9)° respectively, the difference was statistically significant(t=2.50, P<0.05). The KS-C of the two groups three months after the surgery were (82.8±6.2) and (78.1±7.3) respectively, the difference was statistically significant(t=2.05, P<0.05). The KS-F of the two groups 3 months after the surgery were (80.3±10.9) and (71.3±14.3) respectively, the difference was statistically significant(t=2.09, P<0.05).

Conclusion

The KA-TKA can achieve better results than MA-TKA with conventional instruments, and will not increase the difficulty and risk of the operation.

Key words: Osteoarthritis, knee, Arthroplasty, replacement

Desi Ma, Zhiwei Wang, Liang Wen, Xiaoxiong Zhao, Jiang Pan, Lei Zhou, Yuan Lin. Comparison of early clinical outcomes of kinematic and mechanical alignments in total knee arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(02): 163-170.

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Figures/Tables 7

References 34

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分组	例数	年龄(岁)	术前HKA(°)	术前Hb(g/L)	术前AROM(°)	术前KS-C	术前KS-F
KA-TKA组	17	69±7	8±3	135±13	107±10	51±71	46±7
MA-TKA组	19	68±5	7±3	130±11	101±15	56±19	43±8
t值		0.63	1.50	1.08	1.55	1.09	1.17
P值		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

分组	例数	年龄(岁)	术前HKA(°)	术前Hb(g/L)	术前AROM(°)	术前KS-C	术前KS-F
KA-TKA组	17	69±7	8±3	135±13	107±10	51±71	46±7
MA-TKA组	19	68±5	7±3	130±11	101±15	56±19	43±8
t值		0.63	1.50	1.08	1.55	1.09	1.17
P值		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

时间点	HKA(°)	KS-C评分	KS-F评分	Hb(g/L)	AROM(°)
术前	8.2±3.1	50.5±7.3	45.8±7.5	134.6±13.5	107.3±10.3
术后	2.7±1.2	82.8±6.2^a	80.3±10.9^a	113.3±9.1^b	105.6±8.3^c
t值	9.91	16.15	16.42	6.15	1.16
P值	<0.001	<0.001	<0.001	<0.001	>0.05

时间点	HKA(°)	KS-C评分	KS-F评分	Hb(g/L)	AROM(°)
术前	8.2±3.1	50.5±7.3	45.8±7.5	134.6±13.5	107.3±10.3
术后	2.7±1.2	82.8±6.2^a	80.3±10.9^a	113.3±9.1^b	105.6±8.3^c
t值	9.91	16.15	16.42	6.15	1.16
P值	<0.001	<0.001	<0.001	<0.001	>0.05

时间点	HKA(°)	KS-C评分	KS-F评分	Hb(g/L)	AROM(°)
术前	6.5±3.5	55.7±19.2	42.9±7.7	130.1±11.1	100.5±15.2
术后	2.1±1.5	78.1±7.3^a	71.3±14.3^a	111.3±8.2^b	95.4±14.9^c
t值	6.43	3.28	8.26	5.02	1.22
P值	<0.001	<0.01	<0.001	<0.001	>0.05

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