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-determined ‘safe zone’. The most common type of navigation utilises a simple mechanical alignment rod. The surgeon uses experience to judge the position of cup anteversion compared with the patient’s superior shoulder, and the position of inclination when compared
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‘balanced knee replacement’ and how this relates to the native knee. The article addresses the mechanical alignment and rotation of the knee joint, before then reviewing the issues of soft-tissue tensioning. These aspects have influence over how the knee
Personalized Arthroplasty Society, Atlanta, Georgia, USA
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Clinique Orthopédique Duval, Laval, Quebec, Canada
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Department of Knee Surgery, Casa di Cura Solatrix, Rovereto, TN, Italy
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neutral (0°) mechanical alignment (MA) during TKA fails to reproduce individual patient anatomy and joint kinematics ( 2 , 3 , 4 , 5 , 6 ). A variety of personalized implant alignment techniques, including kinematic alignment (KA) ( 7 ), restricted
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Princess Grace Hospital, London, UK
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TKA versus 50 robotic TKA, and found robotic TKA improved accuracy of mechanical alignment and reduced outliers of greater than 3° in planned alignment compared to conventional manual TKA. 25 , 26 Bellemans et al reviewed outcomes in 25 patients
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). Such cases can often be anticipated based on preoperative imaging, and mechanical alignment philosophy is applied. When more constraint is needed, the authors tend to use short cemented stems. In our experience, with rKA, those stems are not impinging
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). This is very reproducible with measured resection instrumentation – we therefore cannot talk of malalignment. This therefore means that certain anatomies may not be adequate for a mechanical alignment technique with measured resection. In those cases
Department of Orthopaedic Surgery, University of Cape Town, SA
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single leg stance; 62 and (2) mechanical alignment, which aims to restore a neutral mechanical axis with orthogonal femoral and tibial resections and subsequent soft tissue balancing, in order to distribute load evenly through the implant bone
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achieve the correct rotational orientation. 62 – 65 Implants can be positioned using kinematic alignment (KA) or mechanical alignment (MA). The goal of KA is to correct the arthritic deformity and restore native knee kinematics by matching the amount of
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. The authors suggested that computer mapping of the residual bone surface after implant removal was a helpful guide in minimizing resection depth, and the preoperative CT scans were unexpectedly helpful in establishing mechanical alignment and resection
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Bellemans J , Colyn W , Vandenneucker H , Victor J . The Chitranjan Ranawat award: is neutral mechanical alignment normal for all patients? The concept of constitutional varus . Clin Orthop Relat Res 2012 ; 470 : 45 - 53
