RESEARCH ARTICLE


Anatomic Versus Mechanically Aligned Total Knee Arthroplasty for Unicompartmental Knee Arthroplasty Revision



Panagiota Toliopoulos1, 2, Marc-Andre LeBlanc1, Jonathan Hutt1, Martin Lavigne1, 2, Francois Desmeules1, Pascal-Andre Vendittoli1, 2, *
1 Maisonneuve-Rosemont Hospital, Department of Surgery, University of Montreal, Montreal, Quebec, Canada
2 Faculty of Medicine, University of Montreal, Montreal, QC, Canada


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© Toliopoulos et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the University of Montreal, Hôpital Maisonneuve-Rosemont, 5415 Blvd L'Assomption, Montréal, QC H1T 2M4, Canada; Tel: 514 252-3400; Fax: 514 252-0115; Email: pa.vendittoli@me.com


Abstract

Objectives:

The purpose of this study was to compare the intra-operative benefits and the clinical outcomes from kinematic or mechanical alignment for total knee arthroplasty (TKA) in patients undergoing revision of failed unicompartmental kneel arthroplasty (UKA) to TKA.

Methods:

Ten revisions were performed with a kinematic alignment technique and 11 with a mechanical alignment. Measurements of the hip-knee-ankle angle (HKA), the lateral distal femoral angle (LDFA), and the medial proximal tibial angle (MPTA) were performed using long-leg radiographs. The need for augments, stems, and constrained inserts was compared between groups. Clinical outcomes were compared using the WOMAC score along with maximum distance walked as well as knee range of motion obtained prior to discharge. All data was obtained by a retrospective review of patient files.

Results:

The kinematic group required less augments, stems, and constrained inserts than the mechanical group and thinner polyethylene bearings. There were significant differences in the lateral distal femoral angle (LDFA) and the medial proximal tibial angle (MPTA) between the two groups (p<0.05). The mean WOMAC score obtained at discharge was better in the kinematic group as was mean knee flexion. At last follow up of 34 months for the kinematic group and 58 months for the mechanical group, no orthopedic complications or reoperations were recorded.

Conclusion:

Although this study has a small patient cohort, our results suggest that kinematic alignment for TKA after UKA revision is an attractive method. Further studies are warranted.

Keywords: Kinematic alignment, Mechanical alignment, Osteoarthritis revision surgery, Total knee arthroplasty, Unicompartmental knee revision.