[Concept of coronal alignment in total knee arthroplasty].

Abstract

Total knee arthroplasty (TKA) is one of the most performed orthopedic surgeries worldwide. For many years, TKA implants were positioned according to a systematic approach known as mechanical alignment, which prioritized implant survival over the restoration of a more physiological knee. A high dissatisfaction rate of 20% after knee prosthesis has led to a rethinking of coronal alignment and a move towards a more personalized approach. With improved instrumentation, new-generation implants and the advent of robotic surgery, it is now possible to better restore the patient's anatomy, to position implants more accurately and to optimize ligament balance in extension and flexion. The aim is to achieve greater patient satisfaction and the perception of a normal or forgotten knee after surgery, while preserving the long-term survival of implants.