Does the Magnitude of Change in Coronal Plane Alignment of the Knee Affect Clinical Outcomes in Functional and Mechanical Alignment Total Knee Arthroplasty?
Kohei Kawaguchi, Mei Lin Tay, Rupert van Rooyen et al.
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In 30 seconds
This randomized controlled trial evaluated the impact of coronal plane alignment changes on clinical outcomes in 236 patients undergoing total knee arthroplasty, comparing functional alignment (FA) and mechanical alignment (MA). The study found that FA resulted in smaller alignment changes and better preservation of preoperative coronal alignment phenotypes, with 42.9% restoration in FA versus 10.3% in MA (P = 0.01).
Key findings
- FA resulted in smaller changes in alignment compared to MA (Δ aHKA P = 0.01; change in JLO P = 0.01).
- 42.9% of patients in the FA group restored their preoperative CPAK phenotype compared to 10.3% in the MA group (P = 0.01).
- In the MA group, restoration of the CPAK phenotype was associated with significantly higher FJS scores.
- A dose-response relationship in the MA group showed greater changes in JLO negatively correlated with FJS.
Why it matters
Understanding the relationship between alignment changes and patient-reported outcomes can guide orthopedic surgeons in selecting the optimal alignment strategy during total knee arthroplasty, potentially improving patient satisfaction and functional recovery.