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Homer Stryker Center

Primary Knee Symposium: Biomechanical Considerations in the Knee

Knee Alignment: What Are We Aiming For? - Arthur Malkani, MD

Slides

Arthur Malkani, MD

The goal in TKA is to alleviate pain, restore function, and achieve longevity via a mechanical axis. Dr. Malkani began his presentation with a review of normal knee alignment, and followed with a discussion of ideal prosthetic alignment, which according to the literature is 2.4 to 7.2 valgus.1

Dr. Malkani started with a review of the important considerations in tibial alignment. PSlide A He then looked at potential tibial component failure mechanisms (varus ≥ 3°; BMI ≥ 33.7),1 the goal for tibial (and femoral) alignment , PSlide B and then compared extramedullary and intramedullary instrumentation. He presented his goal for the level of tibial resection (10mm from the intact guide), and tibial component rotation (do not internally rotate).

On the femoral side, Dr. Malkani again reviewed important considerations for alignment. PSlide C When using an intramedullary femoral guide, he does an 8mm resection and aims for 5-6° valgus.

He concluded his presentation with a summary of main points PSlide D and review of TKA alignment goals. PSlide E

References THERE IS NO NUMBER 2 ON THIS PAGE

  1. Ritter M. et. al. Postoperative Alignment of Total Knee Replacement. CORR. 1994. Vol 299: 153-6.
  2. 2Berend, M. et. al. Tibial Component Failure Mechanisms in Total Knee Arthroplasty. CORR. 2004; 428, 26-34.