Our Summary

This research paper is a review of different surgical techniques used for total knee arthroplasty (TKA), which is a surgery to replace a knee joint that has been damaged by arthritis or injury. Despite advancements in implant design and surgical precision, the outcomes of a traditional technique called mechanically aligned TKA have not improved significantly, suggesting there might be inherent limitations to this technique.

The study aims to classify different alternatives to the traditional method and compare their safety and effectiveness. The researchers looked at four alternative techniques: anatomic alignment, adjusted mechanical alignment, kinematic alignment, and restricted kinematic alignment.

The study found that the kinematic alignment technique showed promising results, particularly for patients with mild to moderate knee deformities due to osteoarthritis. This technique allowed for quicker recovery and generally better functional outcomes compared to the traditional technique.

However, the study also suggests that certain types of knee abnormalities may affect the long-term success of the kinematic alignment technique, requiring additional surgical corrections or the use of the restricted kinematic alignment technique in these cases.

In conclusion, while the kinematic alignment technique seems promising, more long-term studies are needed to fully understand its benefits and to determine the best surgical technique for each patient’s specific situation. The research included in this review was conducted up until February 2017.

FAQs

  1. What is total knee arthroplasty (TKA) and why might it be necessary?
  2. What are the alternative techniques to traditional mechanically aligned TKA and how do they compare in effectiveness and safety?
  3. What are the potential drawbacks or limitations of the kinematic alignment technique for TKA?

Doctor’s Tip

A helpful tip a doctor might tell a patient about knee replacement is to discuss with their surgeon the different surgical techniques available and to consider the kinematic alignment technique as a potential option. It is important for patients to understand the potential benefits and limitations of each technique in order to make an informed decision about their knee replacement surgery. Additionally, patients should follow their surgeon’s post-operative instructions carefully to ensure a successful recovery and optimal outcome.

Suitable For

Patients who are typically recommended for knee replacement surgery include those who have severe knee pain that limits their daily activities, have significant joint damage from arthritis or injury, have failed to find relief from non-surgical treatments such as medication or physical therapy, and have a significant impact on their quality of life.

In particular, patients with osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, and other degenerative conditions of the knee joint are common candidates for knee replacement surgery. Additionally, patients with severe deformities, instability, or stiffness in the knee joint may also benefit from knee replacement surgery.

It is important for patients considering knee replacement surgery to consult with an orthopedic surgeon to determine if they are a suitable candidate for the procedure and to discuss the potential risks and benefits. Additionally, patients should have realistic expectations about the outcomes of the surgery and be committed to participating in post-operative rehabilitation to achieve the best results.

Timeline

Before knee replacement:

  • Patient experiences chronic knee pain, stiffness, swelling, and difficulty walking or performing daily activities
  • Patient undergoes various non-surgical treatments such as physical therapy, medications, injections, and lifestyle modifications to manage symptoms
  • Orthopedic surgeon evaluates the patient’s condition and determines if knee replacement surgery is necessary

After knee replacement:

  • Patient undergoes pre-operative evaluation and preparation, including physical exams, blood tests, and imaging tests
  • Patient undergoes knee replacement surgery, which involves removing damaged parts of the knee joint and replacing them with artificial components
  • Patient stays in the hospital for a few days for post-operative care and physical therapy
  • Patient continues physical therapy and rehabilitation at home or in a rehabilitation facility to regain strength and function in the knee
  • Patient follows up with the orthopedic surgeon for post-operative appointments and monitoring of the knee replacement’s success
  • Patient gradually returns to normal activities and experiences reduced pain and improved mobility in the replaced knee.

What to Ask Your Doctor

Some questions a patient should ask their doctor about knee replacement surgery include:

  1. What are the different surgical techniques available for total knee arthroplasty (TKA)?
  2. Which technique do you recommend for my specific situation and why?
  3. What are the potential risks and complications associated with each surgical technique?
  4. How long is the recovery time for each technique?
  5. Will I need any additional surgical corrections or procedures after the initial knee replacement surgery?
  6. What are the expected outcomes in terms of pain relief and functional improvement for each technique?
  7. Are there any specific factors, such as knee deformities or osteoarthritis severity, that may impact the success of a particular surgical technique?
  8. Are there any long-term studies or research available on the effectiveness of the different surgical techniques?
  9. What is the expected lifespan of the knee implant with each technique?
  10. Are there any alternative treatment options to consider before undergoing knee replacement surgery?

Reference

Authors: Rivière C, Iranpour F, Auvinet E, Howell S, Vendittoli PA, Cobb J, Parratte S. Journal: Orthop Traumatol Surg Res. 2017 Nov;103(7):1047-1056. doi: 10.1016/j.otsr.2017.07.010. Epub 2017 Aug 31. PMID: 28864235