Match-paired study to assess influence of Kinematic versus Mechanical Alignment in Total Knee Replacement
Dissertation
Datum der mündl. Prüfung:2024-01-25
Erschienen:2024-02-09
Betreuer:Prof. Dr. Rolf Haaker
Gutachter:Prof. Dr. Rolf Haaker
Gutachter:Prof. Dr Arndt Schilling
Dateien
Name:Match-paired study to assess influence of Ki...pdf
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Zusammenfassung
Englisch
Introduction: Match-paired study compares the early clinical and radiological outcomes after 6 weeks and 1-year between kinematic alignment total knee arthroplasty (KA TKA) and mechanical alignment total knee arthroplasty (MA TKA). Primary hypothesis were that KA TKAs patients have improved functional outcomes compared to MA TKAs patients? Secondary hypothesis was that there is difference between KA and MA patients. Material and methods: A case-control study was carried out to compare the 6 weeks and 1-year clinical and radiographic outcomes between 24 consecutive KA-TKA patients and 24 matched MA-TKA patients. All patients had implantation with manual instruments and a cemented medial pivot TKA with excision of the PCL. All data were collected prospectively, and outcome scores were patient reported. Results: KA patients had superior values in Forgotten Joint Score (FJS) at 6 weeks and 1-year (KA 77 vs. MA 51) (p=0.05) follow-up. All other outcomes were not statistically significant but new Knee Society Score (KSS) (p=0.02), and in sport section of the Knee Osteoarthritis Outcome Score (KOOS) (p=0.01) after 1 year. Eleven out of 24 patients (46%) in KA group and 7/24 patients (29%) in MA group had limb alignment out of 180°±3°, whereas 17/24 (70%) of KA patients, and 14/24 (58%) of MA patients had orientation of tibial component with more than 3° of varus. No reoperation or revision occurred in either group. Discussion/conclusion: The KA TKA design offers a good efficacy at early-term, with some 6 weeks and 1-year functional performance higher to the ones from MA TKA. Further research is needed to define if those early results will last over time. Keywords: mechanical alignment; kinematical alignment; arthroplasty; total knee arthroplasty; patient related outcome measures; osteoarthritis knee
Keywords: knee arthroplasty; kinematic alignment; tka; alignment; PROMs