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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
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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functional outcomes. The authors originally stated that the study compared KA versus MA but issued a correction stating that in fact, it was an AA technique that was performed. 8 Mechanical alignment (MA) In the 1970s, Freeman and Swanson
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target angle with less variation and outliers when compared with freehand and mechanical alignment techniques ( 81 ). Conclusion Total hip arthroplasty has become one of the most common and successful orthopaedic procedures. Correct cup
Orthopaedic Department, University General Hospital of Larissa, Greece
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perhaps depends on the choice of the different existing alignment techniques and the kinematic design principle of the implant used. 10 , 11 , 19 , 20 Knee alignment Alignment is critical for the long-term survival of TKA and is relevant to the
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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
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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optimizing patella femoral joint kinematics (by replicating the normal valgus angle of the femur it prevents the lateral retinacular structures from becoming over tensioned in flexion, as is the case with a mechanical alignment technique – Fig. 6 ), may in
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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
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technique for TKA For decades, knee components have been positioned following the concept of mechanical alignment (MA), where implants are aligned perpendicular to the femoral and tibial mechanical axes in order to create a straight lower limb with a
Department of Orthopaedic Surgery, University of Cape Town, South Africa
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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
Surgery Department, Hôpital Maisonneuve-Rosemont, Montreal University, Montreal, Québec, Canada
Clinique orthopédique Duval, 1487 Boul des Laurentides, Laval
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Bordeaux Arthroplasty Research Institute - Clinique du Sport Bordeaux-Mérignac 04-06 rue Georges Negrevergne, Mérignac, France
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Department of Orthopedic Surgery and Traumatology, Kantonsspital Baselland, Bruderholz, Switzerland
Clinical Research Group Michael T. Hirschmann, Regenerative Medicine & Biomechanics, University of Basel, Basel, Switzerland
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Department of Surgery, University of California, San Francisco, California, USA
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modifications created by mechanical alignment were linked to frequent mediolateral and flexion–extension joint gap imbalances and patellofemoral dysfunctions ( 9 , 10 , 11 ). Multiple soft tissue release techniques were developed to force the patient’s soft
