PDF herunterladen
J Knee Surg
DOI: 10.1055/a-2544-4116
Special Focus Section

The Benefit of Combining Kinematic Alignment and a Medial Pivot Implant in Total Knee Arthroplasty, The KA–MP Knee: Why and How

Robert N. Steensen
1   Orthopedic One, Columbus, Ohio
2   Department of Orthopedic Surgery, Mount Carmel Health System, Columbus, Ohio
› Institutsangaben Funding None.
› Weitere Informationen
    Lizenzen und Reprints

Abstract

Kinematic alignment (KA) has emerged as an alternative alignment technique for total knee arthroplasty with the goal of duplicating the pre-arthritic joint surface. Medial pivot (MP) total knee implants duplicate the medial stability of the natural knee and recreate the medial rotational axis of the knee. Each has had favorable results. Combining the two, the KA–MP knee, creates a synergy and achieves better results than KA or MP alone.

Keywords

kinematic alignment - medial pivot - KA–MP knee


Publikationsverlauf

Eingereicht: 30. Juni 2024

Angenommen: 21. Februar 2025

Accepted Manuscript online:
25. Februar 2025

Artikel online veröffentlicht:
01. April 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Abdel MP, Ollivier M, Parratte S, Trousdale RT, Berry DJ, Pagnano MW. Effect of postoperative mechanical axis alignment on survival and functional outcomes of modern total knee arthroplasties with cement: A concise follow-up at 20 years. J Bone Joint Surg Am 2018; 100 (06) 472-478
    Suche in Google Scholar
  • 2 Bonner TJ, Eardley WGP, Patterson P, Gregg PJ. The effect of post-operative mechanical axis alignment on the survival of primary total knee replacements after a follow-up of 15 years. J Bone Joint Surg Br 2011; 93 (09) 1217-1222
    Suche in Google Scholar
  • 3 Srivastava AK. Surgical Management of Osteoarthritis of the Knee Work Group, Staff of the American Academy of Orthopaedic Surgeons. Clinical practice guideline summary of surgical management of osteoarthritis of the knee. J Am Acad Orthop Surg 2023; 31 (24) 1211-1220
    Suche in Google Scholar
  • 4 Eckhoff DG, Bach JM, Spitzer VM. et al. Three-dimensional mechanics, kinematics, and morphology of the knee viewed in virtual reality. J Bone Joint Surg Am 2005; 87 (Suppl. 02) 71-80
    Suche in Google Scholar
  • 5 Almaawi AM, Hutt JRB, Masse V, Lavigne M, Vendittoli PA. The impact of mechanical and restricted kinematic alignment on knee anatomy in total knee arthroplasty. J Arthroplasty 2017; 32 (07) 2133-2140
    Suche in Google Scholar
  • 6 Alexander JS, Morris MJ, Lombardi Jr AV, Berend KR, Crawford DA. Influence of kinematic alignment on soft tissue releasing and manipulation under anesthesia rates in primary total knee arthroplasty. Surg Technol Int 2022; 41: 373-378
    Suche in Google Scholar
  • 7 MacDessi SJ, Griffiths-Jones W, Harris IA, Bellemans J, Chen DB. Coronal plane alignment of the knee (CPAK) classification. Bone Joint J 2021; 103-B (02) 329-337
    Suche in Google Scholar
  • 8 Risitano S, Indelli PF. Is “symmetric” gap balancing still the gold standard in primary total knee arthroplasty?. Ann Transl Med 2017; 5 (16) 325-329
    Suche in Google Scholar
  • 9 van Lieshout WAM, Valkering KP, Koenraadt KLM, van Etten-Jamaludin FS, Kerkhoffs GMMJ, van Geenen RCI. The negative effect of joint line elevation after total knee arthroplasty on outcome. Knee Surg Sports Traumatol Arthrosc 2019; 27 (05) 1477-1486
    Suche in Google Scholar
  • 10 Rak D, Rügamer T, Klann L, Nedopil AJ, Rudert M. Setting the distal and posterior condyle of the femoral component to restore the medial pre-arthritic femoral articular surface results in better outcomes after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2023; 31 (12) 5319-5331
    Suche in Google Scholar
  • 11 Ji HM, Han J, Jin DS, Seo H, Won YY. Kinematically aligned TKA can align knee joint line to horizontal. Knee Surg Sports Traumatol Arthrosc 2016; 24 (08) 2436-2441
    Suche in Google Scholar
  • 12 Matsumoto T, Takayama K, Ishida K, Hayashi S, Hashimoto S, Kuroda R. Radiological and clinical comparison of kinematically versus mechanically aligned total knee arthroplasty. Bone Joint J 2017; 99-B (05) 640-646
    Suche in Google Scholar
  • 13 Niki Y, Nagura T, Nagai K, Kobayashi S, Harato K. Kinematically aligned total knee arthroplasty reduces knee adduction moment more than mechanically aligned total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2018; 26 (06) 1629-1635
    Suche in Google Scholar
  • 14 Blakeney W, Clément J, Desmeules F, Hagemeister N, Rivière C, Vendittoli PA. Kinematic alignment in total knee arthroplasty better reproduces normal gait than mechanical alignment. Knee Surg Sports Traumatol Arthrosc 2019; 27 (05) 1410-1417
    Suche in Google Scholar
  • 15 Dossett HG, Estrada NA, Swartz GJ, LeFevre GW, Kwasman BG. A randomized controlled trial of kinematically and mechanically aligned total knee replacements: two-year clinical results. Bone Joint J 2014; 96-B (Suppl. 07) 907-913
    Suche in Google Scholar
  • 16 Elbuluk AM, Jerabek SA, Suhardi VJ, Sculco PK, Ast MP, Vigdorchik JM. Head-to-head comparison of kinematic alignment versus mechanical alignment for total knee arthroplasty. J Arthroplasty 2022; 37 (8S): S849-S851
    Suche in Google Scholar
  • 17 Shelton TJ, Gill M, Athwal G, Howell SM, Hull ML. Outcomes in patients with a calipered kinematically aligned TKA that already had a contralateral mechanically aligned TKA. J Knee Surg 2021; 34 (01) 87-93
    Suche in Google Scholar
  • 18 Yaron BZ, Ilan S, Tomer K, Eran B, Gabriel A, Noam S. Patients undergoing staged bilateral knee arthroplasty are less aware of their kinematic aligned knee compared to their mechanical knee. J Orthop 2021; 23: 155-159
    Suche in Google Scholar
  • 19 Sarzaeem MM, Movahedinia M, Mirahmadi A, Abolghasemian M, Tavakoli M, Amouzadeh Omrani F. Kinematic alignment technique outperforms mechanical alignment in simultaneous bilateral total knee arthroplasty: a randomized controlled trial. J Arthroplasty 2024; 39 (09) 2234-2240
    Suche in Google Scholar
  • 20 Keshmiri A, Maderbacher G, Baier C, Benditz A, Grifka J, Greimel F. Kinematic alignment in total knee arthroplasty leads to a better restoration of patellar kinematics compared to mechanic alignment. Knee Surg Sports Traumatol Arthrosc 2019; 27 (05) 1529-1534
    Suche in Google Scholar
  • 21 Lozano R, Campanelli V, Howell S, Hull M. Kinematic alignment more closely restores the groove location and the sulcus angle of the native trochlea than mechanical alignment: implications for prosthetic design. Knee Surg Sports Traumatol Arthrosc 2019; 27 (05) 1504-1513
    Suche in Google Scholar
  • 22 Howell SM, Shelton TJ, Hull ML. Implant survival and function ten years after kinematically aligned total knee arthroplasty. J Arthroplasty 2018; 33 (12) 3678-3684
    Suche in Google Scholar
  • 23 Howell SM, Akhtar M, Nedopil AJ, Hull ML. Reoperation, implant survival, and clinical outcome after kinematically aligned total knee arthroplasty: a concise clinical follow-up at 16 years. J Arthroplasty 2024; 39 (03) 695-700
    Suche in Google Scholar
  • 24 Laende EK, Richardson CG, Dunbar MJ. A randomized controlled trial of tibial component migration using patient-specific instrumentation versus mechanical alignment using computer-assisted surgery in total knee arthroplasty. Bone Joint J 2019; 101-B (08) 929-940
    Suche in Google Scholar
  • 25 Hasan S, Kaptein BL, Nelissen RGHH, van Hamersveld KT, Toksvig-Larsen S, Marang-van de Mheen PJ. The influence of postoperative coronal alignment on tibial migration after total knee arthroplasty in preoperative varus and valgus knees: A secondary analysis of 10 randomized controlled trials using radiostereometric analysis. J Bone Joint Surg Am 2021; 103 (24) 2281-2290
    Suche in Google Scholar
  • 26 Pinskerova V, Johal P, Nakagawa S. et al. Does the femur roll-back with flexion?. J Bone Joint Surg Br 2004; 86 (06) 925-931
    Suche in Google Scholar
  • 27 Ostermeier S, Stukenborg-Colsman C. Quadriceps force after TKA with femoral single radius. Acta Orthop 2011; 82 (03) 339-343
    Suche in Google Scholar
  • 28 Hamilton DF, Simpson AH, Burnett R. et al. Lengthening the moment arm of the patella confers enhanced extensor mechanism power following total knee arthroplasty. J Orthop Res 2013; 31 (08) 1201-1207
    Suche in Google Scholar
  • 29 Wautier D, Thienpont E. Changes in anteroposterior stability and proprioception after different types of knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2017; 25 (06) 1792-1800
    Suche in Google Scholar
  • 30 Jones CW, Jacobs H, Shumborski S. et al. Sagittal stability and implant design affect patient reported outcomes after total knee arthroplasty. J Arthroplasty 2020; 35 (03) 747-751
    Suche in Google Scholar
  • 31 Pritchett JW. Patients prefer a bicruciate-retaining or the medial pivot total knee prosthesis. J Arthroplasty 2011; 26 (02) 224-228
    Suche in Google Scholar
  • 32 Macheras GA, Galanakos SP, Lepetsos P, Anastasopoulos PP, Papadakis SA. A long term clinical outcome of the medial pivot knee arthroplasty system. Knee 2017; 24 (02) 447-453
    Suche in Google Scholar
  • 33 Karachalios T, Varitimidis S, Bargiotas K, Hantes M, Roidis N, Malizos KN. An 11- to 15-year clinical outcome study of the Advance Medial Pivot total knee arthroplasty: pivot knee arthroplasty. Bone Joint J 2016; 98-B (08) 1050-1055
    Suche in Google Scholar
  • 34 Bordini B, Ancarani C, Fitch DA. Long-term survivorship of a medial-pivot total knee system compared with other cemented designs in an arthroplasty registry. J Orthop Surg Res 2016; 11: 44-48
    Suche in Google Scholar
  • 35 Jeremić DV, Massouh WM, Sivaloganathan S, Rosali AR, Haaker RG, Rivière C. Short-term follow-up of kinematically vs. mechanically aligned total knee arthroplasty with medial pivot components: A case-control study. Orthop Traumatol Surg Res 2020; 106 (05) 921-927
    Suche in Google Scholar
  • 36 French SR, Munir S, Brighton R. A single surgeon series comparing the outcomes of a cruciate retaining and medially stabilized total knee arthroplasty using kinematic alignment principles. J Arthroplasty 2020; 35 (02) 422-428
    Suche in Google Scholar
  • 37 Scott DF, Hellie AA. Mid-flexion, anteroposterior stability of total knee replacement implanted with kinematic alignment: a randomized, quantitative radiographic laxity study with posterior-stabilized and medial-stabilized implants. J Bone Joint Surg Am 2023; 105 (01) 9-19
    Suche in Google Scholar
  • 38 Scott DF, Gray CG. Outcomes are better with a medial-stabilized vs a posterior-stabilized total knee implanted with kinematic alignment. J Arthroplasty 2022; 37 (8S): S852-S858
    Suche in Google Scholar
  • 39 Ettinger M, Tuecking LR, Savov P, Windhagen H. Higher satisfaction and function scores in restricted kinematic alignment versus mechanical alignment with medial pivot design total knee arthroplasty: A prospective randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 2024; 32 (05) 1275-1286
    Suche in Google Scholar