Department of Orthopaedic Surgery, University of Cape Town, South Africa
Search for other papers by Mark Anthony Roussot in
Google Scholar
PubMed
Search for other papers by Georges Frederic Vles in
Google Scholar
PubMed
Search for other papers by Sam Oussedik in
Google Scholar
PubMed
floor during single leg stance. 5 Insall, on the other hand, focussed on restoring neutral mechanical alignment (MA) with orthogonal femoral and tibial resections, subsequently balancing flexion and extension gaps with soft tissue releases ( Fig. 1
Search for other papers by Timothy Lording in
Google Scholar
PubMed
Search for other papers by Sébastien Lustig in
Google Scholar
PubMed
Search for other papers by Philippe Neyret in
Google Scholar
PubMed
A long-held principle in total knee arthroplasty (TKA) is that long-term survival and optimal function are dependent on achieving a post-operative leg alignment within 3° of the neutral mechanical axis. To this end, computer navigation and now
Academic Department of Trauma and Orthopaedics, LGI, University of Leeds, Leeds, UK
Leeds Teaching Hospitals Trust, UK
Search for other papers by Sohail Nisar in
Google Scholar
PubMed
Search for other papers by Jeya Palan in
Google Scholar
PubMed
The Lister Hospital, Chelsea Bridge, London, UK
Centre de l’Arthrose - Clinique du Sport, Bordeaux-Mérignac, France
Search for other papers by Charles Rivière in
Google Scholar
PubMed
Search for other papers by Mark Emerton in
Google Scholar
PubMed
Leeds Teaching Hospitals Trust, UK
Search for other papers by Hemant Pandit in
Google Scholar
PubMed
(2–3° valgus) relative to the mechanical axis of the lower limb, using a ‘systematic approach’. 5 AA aims for a neutral limb alignment with an oblique joint line relative to the mechanical axis of the limb. 6 This was thought to provide
Search for other papers by Nuno Marques Luís in
Google Scholar
PubMed
Search for other papers by Ricardo Varatojo in
Google Scholar
PubMed
The alignment of the lower limb can be evaluated with standard radiographic techniques. However, the mechanical and anatomic axes of the lower limb are only precisely assessed if the ankle and hip positions are known. Standing views allow the
Search for other papers by Charles Rivière in
Google Scholar
PubMed
Search for other papers by Stefan Lazic in
Google Scholar
PubMed
Search for other papers by Oliver Boughton in
Google Scholar
PubMed
Search for other papers by Yann Wiart in
Google Scholar
PubMed
Search for other papers by Loic Vïllet in
Google Scholar
PubMed
Search for other papers by Justin Cobb in
Google Scholar
PubMed
and other improvements such as better wear-resistance with modern polyethylene and better cementation, some authors have started to challenge the basics of the mechanical alignment (MA) technique and recently developed and tested more anatomy
Search for other papers by Ahmed Siddiqi in
Google Scholar
PubMed
Search for other papers by Timothy Horan in
Google Scholar
PubMed
Search for other papers by Robert M. Molloy in
Google Scholar
PubMed
Search for other papers by Michael R. Bloomfield in
Google Scholar
PubMed
Search for other papers by Preetesh D. Patel in
Google Scholar
PubMed
Search for other papers by Nicolas S. Piuzzi in
Google Scholar
PubMed
imprecise bone cuts. 28 Studies have also shown superior results with RA-TKA versus CAN-TKA, with shorter operative duration, less coronal/sagittal deviation and increased accuracy of mechanical axis alignment restoration. 16 , 29 , 30 Newer
Search for other papers by Geert Meermans in
Google Scholar
PubMed
Search for other papers by George Grammatopoulos in
Google Scholar
PubMed
Search for other papers by Moritz Innmann in
Google Scholar
PubMed
Search for other papers by David Beverland in
Google Scholar
PubMed
on the presumption that it is easier for surgeons to evaluate a 90° angle than a 45° angle. These mechanical alignment guides are limited in that they can only achieve one target angle and lack accuracy ( 16 , 17 , 71 ). When operating with the
Orthopaedic Department, University General Hospital of Larissa, Greece
Search for other papers by Theofilos Karachalios in
Google Scholar
PubMed
Search for other papers by George A. Komnos in
Google Scholar
PubMed
method of osteotomy. 21 , 22 Alignment should be considered in three different planes (frontal, sagittal and transverse) and a surgeon should be able to recognize the lower limb mechanical axis, femoral and tibia bone anatomical and mechanical axes
Personalized Arthroplasty Society, Atlanta, Georgia, USA
Search for other papers by Charles Rivière in
Google Scholar
PubMed
Nuffield Orthopaedic Centre, Headington, Oxford, UK
Search for other papers by William Jackson in
Google Scholar
PubMed
Personalized Arthroplasty Society, Atlanta, Georgia, USA
Search for other papers by Loïc Villet in
Google Scholar
PubMed
South-West London Elective Orthopaedic Centre, Epsom, UK
Search for other papers by Sivan Sivaloganathan in
Google Scholar
PubMed
Shamir Medical Center, Zriffin, Israel
Search for other papers by Yaron Barziv in
Google Scholar
PubMed
Département de Chirurgie, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada
Search for other papers by Pascal-André Vendittoli in
Google Scholar
PubMed
reduces the extent of soft tissue releases compared to more traditional mechanical alignment surgery. 10 , 11 In a study assessing 4884 lower limb computerized tomography (CT) scans of patients scheduled for TKA (performed with patient
Department of Orthopaedics, University Hospital of Ghent, Ghent, Belgium
Search for other papers by Aline Van Oevelen in
Google Scholar
PubMed
Search for other papers by Arne Burssens in
Google Scholar
PubMed
Search for other papers by Nicola Krähenbühl in
Google Scholar
PubMed
Search for other papers by Alexej Barg in
Google Scholar
PubMed
Search for other papers by Bernhard Devos Bevernage in
Google Scholar
PubMed
Department of Electromechanics, InViLab research group, University of Antwerp, Antwerp, Belgium
Department of Trauma and Orthopedics, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
Search for other papers by Emmanuel Audenaert in
Google Scholar
PubMed
Search for other papers by Beat Hintermann in
Google Scholar
PubMed
Search for other papers by Jan Victor in
Google Scholar
PubMed
) Intraarticular ankle pressure minimally changed for a 5° change in the mechanical alignment ( P > 0.05). For corrections of 10° and 15°, mean contact pressures decreases respectively by 14% ( P < 0.05) and 17% ( P < 0.05). The mean contact surface area
