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Z Orthop Unfall 2023; 161(01): 93-107
DOI: 10.1055/a-1689-5118
CME-Fortbildung

Kinematisches Alignment bei der Knie-TEP-Implantation

Kinematic Alignment of Total Knee Arthroplasty
Lars-René Tuecking
,
Peter Savov
,
Max Ettinger
,
Henning Windhagen
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Das derzeitige Ziel der Knieendoprothetik ist die Verbesserung der Patientenzufriedenheit nach operativer Versorgung mittels einer Totalendoprothese. Dabei werden verschiedene Ansätze verfolgt. Eines dieser Konzepte ist die Versorgung mittels alternativer Alignmentstrategien. Das in den vergangenen Jahren meistdiskutierte Prinzip ist das sog. kinematische Alignment. Dieser Fortbildungsartikel soll die Grundprinzipien sowie die Versorgungsmöglichkeiten praktisch erläutern.

Abstract

Nowadays, kinematic alignment is a widely used alignment philosophy in total knee arthroplasty. The concept of kinematic alignment respects the patient’s individual prearthrotic anatomy and is based on the reconstruction of the femoral anatomy and thus the axes of motion of the knee joint. Only then the alignment of the tibial component is adapted to the femoral component. By means of this technique soft tissue balancing is reduced to a minimum. Due to the risk of excessive outlier alignment technical assistance or calipered techniques are recommended for precise implementation. This article attempts to provide an understanding of the fundamentals of kinematic alignment, and it focusses on how it differs from alternative alignment strategies and the way the philosophy is implemented in different surgical techniques.

Kernaussagen

  • Das kinematische Alignment respektiert die patientenindividuelle präarthrotische Anatomie.

  • Es basiert auf der Rekonstruktion der Femuranatomie und somit der Bewegungsachsen des Kniegelenks.

  • Die Ausrichtung der tibialen Komponente wird an die Femurkomponente angepasst.

  • Das Weichteilbalancing wird auf ein Minimum reduziert.

  • Zur präzisen Umsetzung ist technische Hilfe in Form von computer- oder roboter-assistierter Technik empfehlenswert.

  • Die Robotik kombiniert statische Parameter mit dynamischen Informationen und generiert somit ein „funktionelles Alignment“.

Schlüsselwörter

kinematic Alignment - KA - TEP - Knie - Arthrose - Roboter-assistierte Chirurgie

Keywords

kinematic alignment - KA - TKA - robotics - knee - alignment philosophy


Publikationsverlauf

Artikel online veröffentlicht:
16. Februar 2023

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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