Kinematic Versus Mechanical Alignment in Total Knee Replacement

  • STATUS
    Recruiting
  • participants needed
    120
  • sponsor
    Hannover Medical School
Updated on 19 February 2024
osteoarthritis
total knee replacement

Summary

This prospective controlled double-blind randomized study compares kinematic and mechanical alignment in TKA (Total knee arthroplasty). A total of 120 patients will be included and the surgery will be performed using CT based 3D printed PSI(Patient Specific Instruments) Cutting guides.

Description

Total knee arthroplasty (TKA) is known, to significantly improve function and satisfaction in arthritic knee patients; nevertheless, a substantial percentage of these patients are not fully satisfied. Thus, several authors reported significantly improved outcomes after slightly under correcting varus knees after TKA. The concept of kinematic alignment (KA) even more addresses the patients individual anatomy with three-dimensional restoration of individual axes, joint lines and joint envelope of laxity. The aim of this prospective randomized study was to demonstrate equivalence between mechanical and kinematic alignment in restoring knee function in terms of subjective and objective outcomes.

In this prospective randomized controlled double-blind study 120 patients with osteoarthritic knees will be treated with a Medial Pivot TKA (Medacta Sphere GMK). The patients are divided into two groups. Group A receive the TKA using mechanical alignment principles, group B receive the kinematic alignment. The surgical technique was equal in both groups. CT-based 3D printed PSI cutting blocks were used for the saw cuts. Pre and postoperative standard x-rays were performed. To determine the subjective and objective outcomes the OKS(Oxford Knee Score), the KSS(Knee Society Sore), the FJS-12(Forgotten Joint Score) and the WOMAC Score were collected.

Details
Condition Repair of knee joint, knee surgery, knee surgery
Age 18-100 years
Clinical Study IdentifierNCT04384913
SponsorHannover Medical School
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

Symptomatic osteoarthritis of the knee
Primary TKA
UCLA Score (University of California, Los Angeles Score)>/= 4
mMPTA: 85- 90
Sum of mMPTA(mechanical medial proximal tibial angle) and mLDFA(mechanical lateral distal femoral angle) between 3varus and 2valgus from neutral

Exclusion Criteria

Minor Patient
Pregnant or breast feeding woman
Difference in the radius of medial and lateral condyles >2mm
Previous osteotomy around the knee
BMI >40
Ligament instability likely to require higher level of constraint
Previous infection or inflammatory disease
Any Patient who cannot or will not provide informed consent for participation in the study
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