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December 10, 2021
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Anatomic, kinematic alignment may have advantages over mechanical alignment for TKA

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Anatomic, kinematic and functional alignment for total knee replacement may have clear and consistent advantages over mechanical alignment, according to a presenter at the Current Concepts in Joint Replacement Winter Meeting.

According to Mark W. Pagnano, MD, use of anatomic, kinematic and functional alignment strategies for TKA may provide easier balancing of the knee.

“You get closer to perfect the first time, fewer releases, fewer re-cuts, and surgeons get immediate positive feedback,” Pagnano said in his presentation.

Mark W. Pagnano
Mark W. Pagnano

He added these alignment strategies may also provide better kinematics and biomechanics. Pagnano noted previously published research showed better patellar kinematics and restoration of natural tibial femoral kinematics, as well as a better reproduction of normal gait, with the use of kinematic alignment.

Finally, these alignment strategies provide better patient outcomes, with published literature reporting better functional outcomes with kinematic alignment compared with mechanical alignment, according to Pagnano.

“The simplest summary that you should keep in mind ... is that in every major area of interest, an alternative alignment technique is either better or no different than mechanical alignment,” Pagnano said. “There are no major examples where the mechanical alignment principles, in fact, prove better.”