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Mechanical or anatomical alignment techniques create a supposedly ‘biomechanically friendly’ but often functionally limited prosthetic knee.
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Alternative techniques for alignment in total knee arthroplasty (TKA) aim at being more anatomical and patient-specific, aiming to improve functional outcomes after TKA.
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The kinematic alignment (KA) technique for TKA has shown good early clinical outcomes. Its role in extreme anatomical variation remains to be defined.
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The restricted KA technique for TKA might be a reasonable option for patients with extreme anatomical variation.
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While unicompartmental knee arthroplasty (UKA) has many advantages over TKA, the revision rate remains higher compared with TKA. One major explanation is the relative ease with which a UKA can be converted to a TKA, compared with revising a TKA. This can be considered as an additional advantage of UKA. Another reason is that surgeons favour revising a UKA to a TKA in cases of degeneration of the other femorotibial compartment rather than performing a relatively simple re-operation of the knee by doing an additional UKA (staged bi-UKA).
Cite this article: EFORT Open Rev 2018;3:1–6. DOI: 10.1302/2058-5241.3.170021
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MSK Lab, Imperial College London, UK
Search for other papers by Charles Rivière in
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Multimodal protocols for pain control, blood loss management and thromboprophylaxis have been shown to benefit patients by being more effective and as safe (fewer iatrogenic complications) as conventional protocols.
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Proper patient selection and education, multimodal protocols and a well-defined clinical pathway are all key for successful day-case arthroplasty.
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By potentially being more effective, cheaper than and as safe as inpatient arthroplasty, day-case arthroplasty might be beneficial for patients and healthcare systems.
Cite this article: EFORT Open Rev 2018;3:130-135. DOI: 10.1302/2058-5241.3.170031
