Neutral mechanical alignment: a requirement for successful TKA: opposes.

نویسنده

  • Johan Bellemans
چکیده

There is increasing evidence that for a number of patients, neutral alignment is not normal. Patients with so-called constitutional varus have been in varus alignment since the end of their growth. Restoring neutral alignment in these cases may not be the best option for these patients since it is abnormal to them. We recently performed a number of observational studies to find out how patients develop constitutional varus, how these patients can be recognized, and which factors contribute. A cohort of 800 young patients was analyzed to determine the influence of activity level on growth and the development of lower-leg alignment. At the same time, 250 asymptomatic adults between 20 and 27 years were analyzed to determine the incidence of constitutional varus. The results showed that 32% of adult men and 17% of adult women had constitutional varus knees with a natural mechanical alignment ≥3° varus. Constitutional varus was associated with increased sports activity during growth and began to become apparent at the time of growth spurt. Based on these data, we believe that an important fraction of the normal population has a natural alignment at the end of growth of ≥3° varus. This may be a consequence of Hueter-Volkmann's law. Restoration of mechanical alignment to neutral in these cases therefore may not be desirable and in fact unnatural for them.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Neutral mechanical alignment: a requirement for successful TKA: affirms.

Restoration of an overall neutral mechanical axis has been a long-held tenet in total knee arthroplasty (TKA). Numerous biomechanical, finite element, and clinical studies have demonstrated that coronal malalignment, particularly varus, is associated with increased strain, higher failure rates, and, in some cases, poorer outcomes. With advances in computer-assisted navigation, 3-dimensional ima...

متن کامل

The current role of coronal plane alignment in Total Knee Arthroplasty in a preoperative varus aligned population: an evidence based review.

BACKGROUND Based on historical data, the current standard of care in Total Knee Arthroplasty (TKA) is to restore the overall alignment to a neutral mechanical axis of 0°±3° or even slight valgus. However, there is significant controversy in literature regarding intentionally placing the TKA in the patient's physiologic, rather than neutral (0±3°), mechanical alignment. QUESTIONS/PURPOSES The ...

متن کامل

Navigated versus Conventional Total Knee Arthroplasty. Are There Improved Gait Kinematics or Clinical Benefits?

INTRODUCTION Total Knee Arthroplasty (TKA) has been established as a successful operation to relieve pain and restore function in patients with severe knee osteoarthritis with a survival rate of around 92% for 12 years [1]. The success of this operation is dependent on various factors such as the preoperative characteristics of the patient, the implant selected [2] and importantly the post oper...

متن کامل

Component position alignment with patient-specific jigs in total knee arthroplasty.

BACKGROUND The failure to restore mechanical alignment and appropriate rotational axis intraoperatively has been described as one of the most common causes of implant failure in total knee arthroplasty (TKA). Both conventional and computer-assisted TKA have their limitations. Patient-specific jigs (PSJ) offer a possible alternative method for TKA. The aim of this study was to investigate if the...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Orthopedics

دوره 34 9  شماره 

صفحات  -

تاریخ انتشار 2011