TKR study showed better clinical results at 2 years for kinematic than mechanical alignment techniques

LAS VEGAS — In results of a randomized controlled study presented at the American Academy of Orthopaedic Surgeons Annual Meeting, an individualized knee alignment technique for total knee replacement performed with patient-specific guides was associated with mean Oxford Knee Scores, WOMAC scores and combined Knee Society scores that were better than those for mechanically aligned knees treated with the same knee prosthesis.

“Although mechanical alignment is a long-standing widely accepted principle of total knee replacement, this study shows that alignment technique based on restoring pre-arthritic kinematics for each patient’s particular knee can produce significantly better results until 2 years with regard to pain, function and motion compared to mechanically aligned,” Harold G. Dossett, MD, of Scottsdale, Ariz., said. “Every 2-year clinical result was better in the kinematically aligned group,” he said.

Investigators randomized 88 patients (88 knees) scheduled for total knee replacement (TKR) into two groups of 44 patients who underwent TKR either aligned kinematically or mechanically.

Mechanical alignment involved the use of conventional instruments.

The same model of cruciate-retaining prosthesis was implanted in each knee and the patients, clinical care professionals and radiographers were blinded to the alignment method used for each patient.

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