Consequences of Malalignment in Total Knee Arthroplasty: Few if Any-Opposes
“Failure” in TKA remains multifactorial. Alignment plays an important role in loading of the underlying bone and has been associated with osseous failure and implant loosening in both metal backed and all poly tibial components in long term studies on large cohorts of total knee arthroplasties. Importantly, varus malalignment of a TKA in obese patients (BMI >33) has resulted in early tibial component loosening via medial tibial osseous collapse. Furthermore, in a multivariate analysis, varus limb alignment has been associated with accelerated poly wear in both TKA and UKA. Certainly not all knees in varus coronal alignment fail. We have further examined implant, surgical, and patient factors associated with this pathophysiology both clinically and in our laboratory.
Center for Hip and Knee Surgery, Joint Replacement Surgeons of Indiana Research Foundation, St. Francis Hospital Mooresville, Mooresville, IN, USA
Address reprint requests to Michael Berend, MD, Center for Hip and Knee Surgery, Joint Replacement Surgeons of Indiana Research Foundation, St. Francis Hospital Mooresville, 1199 Hadley Rd., Mooresville, IN 46158
No funds were received directly for this paper. Dr. Berend receives royalties for Intellectual Property from Biomet, the Joint Replacement Surgeons of Indiana Research foundation receives research support from Biomet, St. Francis Hospital, MCS, ERMI, and Javelin Pharmaceuticals for clinical trials, clinical database, and basic science research.
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