AAOS2017: Similar short-term micromotion between kinematic & mechanical strategies in TKA

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
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Synopsis
51 patients scheduled for total knee arthroplasty were randomized to either a kinematic alignment strategy using MRI-based patient specific instrumentation or to traditional mechanical alignment strategy using computer navigation. Patients were assessed for implant migration over the first 2 years postoperatively using radiostereometric analysis. Results demonstrated no Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
Kinematic alignment in TKA with the use of patient-specific cutting blocks has been an emerging technique in the past few years. It contrasts the traditional mechanical alignment technique in that restoration is based on patient anatomy, as opposed to restoration to a neutral mechanical axis. As earlier research has identified deviation from a neutral mechanical axis as a potential risk factor for aseptic loosening, high-quality research was necessary comparing rates of aseptic loosening between kinematic and mechanical alignment techniques in TKA.
What was the principal research question?
In total knee arthroplasty, is there any significant difference component 2-year micromotion and incidence of early aseptic loosening between patients who received kinematic alignment with patient-specific instrumentation, and patients who received mechanical alignment with computer navigation?
Population: 51 patients scheduled for total knee arthroplasty. All cases were performed using a cruciate-retaining total knee system with cement fixation.
Intervention: PSI group: Patients underwent total knee arthroplasty with a kinematic alignment strategy using MRI-based patient-specific instrumentation.
Comparison: Navigated group: Patients underwent total knee arthroplasty with a traditional mechanical alignment strategy using computer navigation.
Outcomes: Radiostereometric analysis was performed to assess maximum total point motion of the tibial component. Patient-reported outcome measures, including the EuroQoL 5-dimensions and Oxford Knee Score, were also assessed.
Methods: RCT
Time: Follow-up was scheduled for 6 weeks and 3, 6, 12 and 24 months postoperatively.
What were the important findings?
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How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.