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J Knee Surg 2019; 32(10): 1033-1038
DOI: 10.1055/s-0039-1694796
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Kinematically Aligned TKA Aligns the Ankle Joint Line Closer to Those of the Native Ankle than Mechanically Aligned TKA in Bipedal Stance

Jung-Taek Kim  ‡   *
1   Department of Orthopedic Surgery, Ajou University School of Medicine and Graduate School of Medicine, Suwon, Gyeonggi-do, South Korea
,
Jun Han‡   *
2   Department of Orthopaedics, Yanbian No. 2 People’s Hospital, Jilin, China
,
Sumin Lim
1   Department of Orthopedic Surgery, Ajou University School of Medicine and Graduate School of Medicine, Suwon, Gyeonggi-do, South Korea
,
Quan Hu Shen
1   Department of Orthopedic Surgery, Ajou University School of Medicine and Graduate School of Medicine, Suwon, Gyeonggi-do, South Korea
3   Department of Orthopaedics, First People's Hospital of Suqian City, Jiangsu, China
,
Ye Yeon Won
1   Department of Orthopedic Surgery, Ajou University School of Medicine and Graduate School of Medicine, Suwon, Gyeonggi-do, South Korea
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Publikationsverlauf

10. Februar 2019

03. Juli 2019

Publikationsdatum:
21. August 2019 (online)

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Abstract

Mechanically aligned total knee arthroplasty (MATKA) aims to make alignment of the hip, knee, and ankle straight unexceptionally. However, emerging evidence suggests that unexceptional straightening the mechanical axis of the lower limb may lead to clinical and radiological problems of the ankle joint. By contrast, kinematically aligned total knee arthroplasty (KATKA) strives to restore the articular surface of the prearthritic knee. In this study, we examined results from KATKA and MATKA to determine which surgery restores the ankle joint orientation closer to the native ankle joint in bipedal stance and hypothesized that KATKA, rather than MATKA, would be more effective. Data from long-leg standing radiographs of 60 healthy adults (control group, n = 120 knees), patients who underwent MATKA (n = 90 knees), and patients who underwent KATKA (n = 90 knees) were retrospectively reviewed. The hip–knee–ankle angle, orientation of the tibial plafond and the talar dome relative to the ground (G-plafond and G-talus, respectively), and orientation of the plafond relative to the mechanical axis of the limb (M-plafond and M-talus, respectively) were measured and analyzed for comparison. Results show that bipedal stance alignment in patients who underwent KATKA (G-plafond: −0.65 ± 3.03 and G-talus: −1.72 ± 4.02) were not significantly different to native ankle joint alignment indicated by the control group. Compared with the native ankle joint measured in the control group (G-plafond: −0.76 ± 2.69 and G-talus: −1.30 ± 3.25), the tibial plafond and talar dome significantly tilted laterally relative to the ground in ankle joints after MATKA (G-plafond: −2.32 ± 3.30 and G-talus: −2.97 ± 3.98, p = 0.001 and p = 0.004, respectively). Thus, postoperative ankle joint line orientation after KATKA was horizontal to the floor and closer to that of native ankle joints than those after MATKA. The level of evidence is Level III.

Keywords

knee - ankle - joint - arthroplasty

* Jung-Taek Kim and Jun Han contributed equally to this work and should be considered co-first authors.