Revision of Well-Fixed Mechanically-Aligned Total Knee Arthroplasty Using Kinematic Alignment for the Restoration of Joint Line Obliquity: Report of a Surgical Technique.

Abstract

Despite advances in technology and procedures, primary total knee arthroplasty can still result in an unsatisfied patient up to 20% of the time. Many indications for revising total knee arthroplasty have been established, including infection, aseptic loosening, wear, and instability. A newer indication being used in our center is that of a mechanically aligned knee, in which the prosthetic joint line has been substantially altered with respect to the native joint line. In this surgical technique report, we describe a method of revising a painful mechanically aligned total knee arthroplasty using the principles of kinematic alignment, using either the patient's preoperative long-axis radiographs, if available, or those of their contralateral limb, as a guide for the measurement of native joint line obliquity. Although this may be controversial, in our practice, this diagnosis has become an established indication for revision knee arthroplasty, with high success rates and patient satisfaction. In this brief surgical technique report, we present the details of one of our cases.