Alignment strategies in total knee arthroplasty and the patellofemoral joint: A systematic review.
Anne Ruth van Meijeren, Danielle Langeloo, Marrigje Meijer et al.
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In 30 seconds
This systematic review evaluated the impact of different alignment strategies in total knee arthroplasty (TKA) on patellofemoral outcomes. Eight studies were included, revealing that kinematic alignment (KA) and restricted kinematic alignment (rKA) better restored native trochlear morphology compared to mechanical alignment (MA) and functional alignment (FA). However, KA was associated with increased internal femoral component rotation.
Key findings
- KA and rKA restored trochlear morphology better than MA and FA, reducing outliers in the anterior trochlear line.
- MA was linked to greater trochlear translation, indicating worse patellar tracking.
- KA showed increased internal femoral component rotation, with more outliers beyond safe thresholds.
- FA provided more consistent rotational positioning, generally within safe limits.
Why it matters
Understanding the effects of alignment strategies on patellofemoral outcomes is crucial for optimizing surgical techniques in TKA, potentially improving patient satisfaction and functional results.
What to keep in mind
The review included studies of varying quality, with only eight meeting inclusion criteria, limiting the strength of the conclusions.