Early clinical outcomes comparison of kinematic and mechanical alignments in total knee arthroplasty

doi:10.3877/cma.j.issn.1674-134X.2022.04.006

Abstract

Abstract:

Objective

To explore and compare the early clinical results between kinematic alignment using special tools and mechanical alignment in total knee arthroplasty.

Methods

A retrospective analysis was performed on patients who underwent unilateral total knee arthroplasty due to knee osteoarthritis with a follow-up time of more than three months and complete follow-up data.in Beijing Chaoyang Hospital, Capital Medical University from March 2019 to March 2021. The patients with inflammatory arthropathy such as rheumatoid arthritis, severe misalignment of patellofemoral joint, and previous knee collateral ligament or posterior cruciate ligament injury were excluded. According to alignment method, patients were divided into special tools kinematically aligned total knee arthroplasty (KA-TKA) group and mechanically aligned total knee arthroplasty (MA-TKA) group. The hip-knee-ankle (HKA) angle before and after the surgery, the knee joint clinical score (KS-C), the knee joint functional score (KS-F) before and three months after the surgery were recorded, as well as the postoperative forgotten joint score (FJS). Independent sample t test was used to compare the data.

Results

A total of 162 patients were enrolled, including 82 in the KA-TKA group and 80 in the MA-TKA group. There was no statistically significant difference in the postoperative HKA angle between the two groups (P>0.05). Three months after the surgery, the KS-C score (t=2.259), KS-F score (t=1.994) and FJS score (t=2.945) in the KA-TKA group were higher than those in the MA-TKA group, the differences between the two groups were statistically significant (all P<0.05).

Conclusion

KA-TKA has similar postoperative lower limb alignment, better clinical performance and higher knee function, and a higher FJS compared with MA-TKA.

Key words: Osteoarthritis, knee, Arthroplasty, replacement

Liang Wen, Zhiwei Wang, Desi Ma, Qingxi Zhang, Xiaoxiong Zhao, Lei Zhou, Jiang Pan, Yuan Lin, Tiebing Qu. Early clinical outcomes comparison of kinematic and mechanical alignments in total knee arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(04): 419-424.

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References 33

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分组	例数	年龄(岁)	BMI(kg/m²)	术前HKA(°)	术前KS-C	术前KS-F
KA-TKA组	82	70±7	27±3	8±4	52±18	34±20
MA-TKA组	80	71±7	27±4	7±4	50±16	30±16
t值		0.924	0.243	0.301	0.570	1.331
P值		>0.05	>0.05	>0.05	>0.05	>0.05

分组	例数	年龄(岁)	BMI(kg/m²)	术前HKA(°)	术前KS-C	术前KS-F
KA-TKA组	82	70±7	27±3	8±4	52±18	34±20
MA-TKA组	80	71±7	27±4	7±4	50±16	30±16
t值		0.924	0.243	0.301	0.570	1.331
P值		>0.05	>0.05	>0.05	>0.05	>0.05

分组	例数	术后HKA(°)	术后3个月KS-C	术后3个月KS-F	术后3个月FJS
KA-TKA组	82	2.7±1.9	78.9±7.7	75.9±10.3	74.2±9.9
MA-TKA组	80	2.3±1.4	76.2±7.3	72.7±9.9	69.7±9.0
t值		1.528	2.259	1.994	2.945
P值		>0.05	0.025	0.048	0.004

分组	例数	术后HKA(°)	术后3个月KS-C	术后3个月KS-F	术后3个月FJS
KA-TKA组	82	2.7±1.9	78.9±7.7	75.9±10.3	74.2±9.9
MA-TKA组	80	2.3±1.4	76.2±7.3	72.7±9.9	69.7±9.0
t值		1.528	2.259	1.994	2.945
P值		>0.05	0.025	0.048	0.004

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