Open Access
Review
Table 1
Surgical parameters for each kind of alignment.
Mechanical alignment | Kinematic alignment | Inverse kinematic alignment | Restricted alignment | Functional alignment | ||
---|---|---|---|---|---|---|
Femoral component | Flexion | Follows distal femoral bowing | Follows distal femoral bowing | Follows distal femoral bowing | Follows distal femoral bowing | Follows distal femoral bowing |
Target: 0 to 5° of flexion | Target: 2 ± 3° | Target: 2 ± 3° | Target: 2 ± 3° | Target: 0 to 5° of flexion | ||
Distal cut | Systematic and perpendicular to the femoral mechanical axis | Parallel to the distal femoral joint line (considering wear) | Parallel to the distal femoral joint line (considering wear) | Correct to < 5°, then Parallel to the distal femoral joint line (considering wear) | Parallel to the distal femoral joint line (considering wear) | |
Target: 0° | Target: < 5° | Target: 0 to 5° | ||||
Posterior cut | External or neutral rotation relative to posterior condylar line. | Parallel to the posterior condylar line | Parallel to the posterior condylar line | Parallel to the posterior condylar line | Surgical trans epicondylar axis; ± 3° | |
Measured resection or gap-balancing techniques. | ||||||
Posterior or anterior referencing techniques | ||||||
Mediolateral | Slightly lateralized | Centered on the notch | Centered on the notch | Centered on the notch | Centered on the distal femur | |
Tibial component | Coronal cut | Systematic and perpendicular to the tibial mechanical axis | Parallel to proximal tibial joint line (considering wear) | Parallel to proximal tibial joint line (considering wear) within safe zone of 84° to 92° | Correct to < 5°, then Parallel to proximal tibial joint line (considering wear) | Perpendicular to the tibial mechanical axis |
Target: 0° | Target: −6° to 9° | Target: −6° to 2° | Target: < 5° | Target: 0 ± 3° | ||
Slope | Systematic. Between 2° and 7° relative to sagittal tibial mechanical axis | Parallel to the medial plateau slope | Parallel to the medial plateau slope | Parallel to the medial plateau slope | Parallel to the medial plateau slope; Target: 0° to 3° | |
Rotation | Towards the medial third of the tibial tuberosity | Parallel to lateral plateau long-axis | Parallel to lateral plateau long-axis | Parallel to lateral plateau long-axis | 0 to 5° of external rotation to Akagi’s line | |
Knee balancing | Soft tissues | Tibial cut | Femoral cut (distal and/or posterior) | Tibial cut + Soft tissues | Femoral and tibial positioning + Soft tissues | |
Soft tissue Release | Femorotibial joint | Frequent | None | None | Sometimes | Sometimes |
Lateral retinaculum | Sometimes | Rarely | Rarely | Rarely | Rarely | |
Technologies | All | All | Robotic-assisted | All | Robotic-assisted |
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