Novel technique for achieving the under-correction of native tibial varus in calipered restricted kinematically aligned total knee arthroplasty - A validation study

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2024-11-20 DOI:10.1016/j.jcot.2024.102832

Arghya Kundu Choudhury , Shivam Bansal , Souvik Paul , S. Raja Balgovind , Sajid Ansari , Roop Bhushan Kalia

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引用次数: 0

Abstract

Purpose

Restricted kinematic alignment (rKA) TKA is relatively newer technique for achieving an overall under-corrected limb alignment. The present study aims to provide an easy and reproducible technique for achieving calipered rKA-TKA (crKA-TKA) using routine instrumentation.

Method

A prospective study was conducted including 30 patients (30 knees). All patients underwent crKA-TKA by the same surgeon. Pre-operatively all patients underwent long film standing radiographs, and coronal angles were measured to plan tibial bony cuts and the femoral axis angle (FAA) to restore tibial varus under correction and native distal femoral anatomy, respectively. Intra-operatively while taking tibial cuts, the alignment rod was noted to be always pointing towards the “third metatarsal” of the ipsilateral foot.

Results

30 patients underwent total knee replacement with crKA technique. Angular corrections were satisfactory with all patients reaching the target MPTA of 87.48 ± 0.78 and LDFA of 90.301 ± 2.66 as planned, with an overall under-corrected limb alignment. HKA was achieved within a target of < ± 3 degrees of the native knee (3.56 ± 1.29). Post-operative radiological parameters were checked by two separate observers with excellent intra-class correlation coefficients.

Conclusion

The present study validates a novel intra-operative technique of confirming an under-corrected native tibial varus while performing crKA-TKA. The radiological outcomes of the study confirm that with careful pre-operative planning, coronal angular targets were easily achievable with very less outliers. Study further establishes that this method of calipered technique in rKA-TKA using routine digital templating software and standard instrumentations is an alternative method of executing rKA.

Level of evidence

IV, Prospective case series.

查看原文本刊更多论文

在卡钳限制的运动学对齐全膝关节置换术中实现原生胫骨内翻矫正的新技术--一项验证研究

目的限制性运动对位（rKA）TKA 是一种相对较新的技术，可实现整体欠矫正肢体对位。本研究旨在提供一种简便、可重复的技术，使用常规器械实现校正后的 rKA-TKA（crKA-TKA）。所有患者均由同一位外科医生进行 crKA-TKA 手术。术前，所有患者均接受了长片立位X光片检查，并测量了冠状角，以规划胫骨骨性切口和股骨轴角（FAA），从而分别恢复胫骨外翻矫正下和原生股骨远端解剖结构。术中进行胫骨切口时，注意对位杆始终指向同侧足的 "第三跖骨"。所有患者都按计划达到了 87.48 ± 0.78 的 MPTA 目标值和 90.301 ± 2.66 的 LDFA 目标值，角度校正效果令人满意，但肢体对线总体校正不足。HKA的目标值为原生膝关节的< ± 3度（3.56 ± 1.29）。本研究验证了一种新颖的术中技术，即在进行 crKA-TKA 时确认未充分矫正的原生胫骨外翻。研究的放射学结果证实，通过仔细的术前规划，冠状角度目标很容易实现，异常值非常小。研究进一步证实，这种使用常规数字模板软件和标准器械的rKA-TKA卡钳技术是实施rKA的另一种方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.