Alignment in total knee arthroplasty- systematic versus individualised alignment?

What is it about?

Alignment is regarded as a hot topic in total knee arthro- plasty (TKA). For a long time, a neutral mechanical alignment was proposed as the only reliable, durable option in TKA. With the increasing quality and durability of polyethylene inlays, many knee surgeons are increasingly gaining or regaining interest in alternative alignment methods such as anatomic or kinematic alignment. Some authors are even openly questioning the concept of mechani- cal alignment. In fact, this is accompanied by a more pro- found understanding of the distribution of knee alignment among patient populations. In particular, the morphology and asymmetry of the distal femur has been investigated in several studies.

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Why is it important?

When it comes to alignment, systematic alignment can be differentiated from more individualised alignment strategies. A systematic approach means that this alignment strategy is used in every patient homogeneously. Currently, a systematic mechanical alignment strategy is most widely used by those of us who are knee surgeons. In contrast, a more individualised alignment strategy would adapt the alignment strategy with regard to the indi- vidual constitutional alignment of each patient. It aims to restore the individual patient alignment.

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