National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK
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National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK
North Bristol NHS Trust, Southmead Hospital, Bristol, UK
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Introduction The primary reasons that patients elect to undergo total knee replacement (TKR) are to gain improvements in pain and walking ability. 1 However, patients often have high expectations of the outcome of their TKR and want more
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Department of Orthopaedic Surgery, St Vincent’s Hospital, Fitzroy, Australia
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Department of Orthopaedic Surgery, St Vincent’s Hospital, Fitzroy, Australia
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Introduction The growing burden of knee osteoarthritis presents a significant challenge facing many communities. 1 Total knee replacement (TKR) remains the only definitive treatment option available for advanced arthritis, and this has
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Introduction Total knee replacement (TKR) is a cost-effective surgical procedure. 1 According to the national joint registry, 2 274,495 total knee replacements were performed in England, Wales, Northern Ireland and the Isle of Man in
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Introduction Although several surgical approaches to the knee exist, the medial parapatellar approach has been used in 93% of primary total knee replacements (TKRs) performed in England and Wales between 2004 and 2014. 1 This approach
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Kaplan Joint Center, Department of Orthopaedics, Newton-Wellesley Hospital, Newton, Massachusetts, USA
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,133 primary total knee replacements carried out in the UK; 925,320 (94.66%) of these primary total knee replacements were cemented, with 43,011 (4.4%) uncemented and 9,157 (0.94%) hybrid. Since 2003, the use of cemented fixation in primary TKA has increased
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2021 in relevant databases (PubMed and Embase from 1985 to May 2021). To correctly identify the relevant studies, the terminologies total knee replacement as well as total knee arthroplasty were used. In order to conduct one united search where all
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-rich plasma (PRP) or hyaluronic acid may be considered. Orthotic treatments such as a hinged offloader brace can also be employed. Operative management might involve a total knee replacement (TKR), with other options being a uni-compartmental knee replacement
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. Buechel FF Femino FP D’Alessio J . Primary exchange revision arthroplasty for infected total knee replacement: a long-term study . Am J Orthop (Belle Mead NJ) 2004 ; 33 : 190 – 198 . 40. Tibrewal S
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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Introduction Over 100,000 total knee replacements (TKR) are performed annually for painful end-stage osteoarthritis (OA) in the UK. 1 The main reason for undertaking a TKR is to provide pain relief as well as improving function and
Personalized Arthroplasty Society, Atlanta, Georgia, USA
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Nuffield Orthopaedic Centre, Headington, Oxford, UK
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Personalized Arthroplasty Society, Atlanta, Georgia, USA
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South-West London Elective Orthopaedic Centre, Epsom, UK
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Shamir Medical Center, Zriffin, Israel
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Département de Chirurgie, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada
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The Kinematic Alignment (KA) technique for total knee arthroplasty (TKA) is an alternative surgical technique aiming to resurface knee articular surfaces.
The restricted KA (rKA) technique for TKA applies boundaries to the KA technique in order to avoid reproducing extreme constitutional limb/knee anatomies.
The vast majority of TKA cases are straightforward and can be performed with KA in a standard (unrestricted) fashion.
There are some specific situations where performing KA TKA may be more challenging (complex KA TKA cases) and surgical technique adaptations should be included.
To secure good clinical outcomes, complex KA TKA cases must be preoperatively recognized, and planned accordingly.
The proposed classification system describes six specific issues that must be considered when aiming for a KA TKA implantation.
Specific recommendations for each situation type should improve the reliability of the prosthetic implantation to the benefit of the patient.
The proposed classification system could contribute to the adoption of a common language within our orthopaedic community that would ease inter-surgeon communication and could benefit the teaching of the KA technique. This proposed classification system is not exhaustive and will certainly be improved over time.
Cite this article: EFORT Open Rev 2021;6:881-891. DOI: 10.1302/2058-5241.6.210042
