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Academic Department of Trauma and Orthopaedics, LGI, University of Leeds, Leeds, UK
Leeds Teaching Hospitals Trust, UK
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The Lister Hospital, Chelsea Bridge, London, UK
Centre de l’Arthrose - Clinique du Sport, Bordeaux-Mérignac, France
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Leeds Teaching Hospitals Trust, UK
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Kinematic alignment (KA) is an alternative philosophy for aligning a total knee replacement (TKR) which aims to restore all three kinematic axes of the native knee.
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Many of the studies on KA have actually described non-KA techniques, which has led to much confusion about what actually fits the definition of KA.
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Alignment should only be measured using three-dimensional cross-sectional imaging. Many of the studies looking at the influence of implants/limb alignment on total knee arthroplasty outcomes are of limited value because of the use of two-dimensional imaging to measure alignment, potentially leading to inaccuracy.
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No studies have shown KA to be associated with higher complication rates or with worse implant survival; and the clinical outcomes following KA tend to be at least as good as mechanical alignment.
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Further high-quality multi-centre randomized controlled trials are needed to establish whether KA provides better function and without adversely impacting implant survival.
Cite this article: EFORT Open Rev 2020;5:380-390. DOI: 10.1302/2058-5241.5.200010
