Comparison of kinematic alignment and mechanical alignment to guide gait after total knee arthroplasty

doi:10.12307/2022.060

Abstract

Abstract: BACKGROUND: At present, the alignment methods commonly used in knee arthroplasty include mechanical alignment and kinematic alignment. The imaging and functional evaluation of the two surgical methods have been studied to some extent, but the gait conditions of patients with the two surgical methods have been studied.
OBJECTIVE: To explore the difference in kinematic alignment and mechanical alignment to guide gait analysis after total knee arthroplasty.
METHODS: From January 2017 to June 2019, 50 hospitalized patients with inverted knee osteoarthritis were selected. According to the operation method, they were divided into kinematic alignment group (25 cases) and mechanical alignment group (25 cases). The patient’s knee Hospital for special surgery score, visual analogue scale score, and gait parameters (stride speed, stride frequency, stride length, stance and swing phase flexion angle, varus angle, internal and external rotation angle and adduction torque) were used as reference indicators. Follow-up time was 1 year.
RESULTS AND CONCLUSION: (1) All patients successfully completed the follow-up, without incision infection, pulmonary embolism, joint dysfunction or other complications. (2) Compared with that before operation, visual analogue scale score and Hospital for special surgery score were significantly improved at 1 year after operation in both groups (P < 0.05). Hospital for special surgery score and visual analogue scale score were not significantly different between the two groups at 1 year after operation (P > 0.05). (3) Except swing phase varus or valgus angle, the gait parameters of the two groups were significantly improved at 1 year after operation compared with those before operation (P < 0.05). There was no statistical difference in stride frequency, standing phase, swing phase flexion and extension, internal and external rotation angle and swing phase varus or valgus angle (P > 0.05). There were significant differences in stride speed, stride length, varus or valgus angle and adduction torque in standing phase (P < 0.05). (4) It is concluded that both kinematic alignment-total knee arthroplasty and mechanical alignment-total knee arthroplasty can significantly improve the postoperative function and gait of the knee joint. However, some patients with kinematic alignment-total knee arthroplasty have residual physiological varus after surgery, but it can more effectively reduce the knee adduction torque, so as to obtain a good treatment effect.

Key words: kinematic alignment, mechanical alignment, total knee arthroplasty, gait analysis

CLC Number:

Pan Hao, Zhao Huihui, Wang Jiangjing, Wang Feng, Wang Peng, Shi Qiuling, Guo Jin, Li Lin, Liu Guoqiang. Comparison of kinematic alignment and mechanical alignment to guide gait after total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(3): 365-370.

Figures/Tables 8

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