The aims of this study were: 1) to describe extended restricted kinematic alignment (E-rKA), a novel alignment strategy during robotic-assisted total knee arthroplasty (RA-TKA); 2) to compare residual medial compartment tightness following virtual surgical planning during RA-TKA using mechanical alignment (MA) and E-rKA, in the same set of osteoarthritic varus knees; 3) to assess the requirement of soft-tissue releases during RA-TKA using E-rKA; and 4) to compare the accuracy of surgical plan execution between knees managed with adjustments in component positioning alone, and those which require additional soft-tissue releases. Patients who underwent RA-TKA between January and December 2022 for primary varus osteoarthritis were included. Safe boundaries for E-rKA were defined. Residual medial compartment tightness was compared following virtual surgical planning using E-rKA and MA, in the same set of knees. Soft-tissue releases were documented. Errors in postoperative alignment in relation to planned alignment were compared between patients who did (group A) and did not (group B) require soft-tissue releases.Aims
Methods
Single-shot adductor canal block (ACB) after total knee arthroplasty (TKA) for postoperative analgesia is a common modality. Patients can experience breakthrough pain when the effect of ACB wears off. Local anaesthetic infusion through an intra-articular catheter (IAC) can help manage breakthrough pain after TKA. We hypothesized that combined ACB with ropivacaine infusion through IAC is associated with better pain relief compared to ACB used alone. This study was a prospective double-blinded placebo-controlled randomized controlled trial to compare the efficacy of combined ACB+ IAC-ropivacaine infusion (study group, n = 68) versus single-shot ACB+ intra-articular normal saline placebo (control group, n = 66) after primary TKA. The primary outcome was assessment of pain, using the visual analogue scale (VAS) recorded at 6, 12, 24, and 48 hours after surgery. Secondary outcomes included active knee ROM 48 hours after surgery and additional requirement of analgesia for breakthrough pain.Aims
Methods
The restoration of knee alignment is an important
goal during total knee arthroplasty (TKA). In the past surgeons aimed
to restore neutral limb alignment during surgery. However, previous
studies have demonstrated alignment to be dynamic, varying depending
on the position of the limb and the degree of weight-bearing, and
between patients. We used a validated computer navigation system
to measure the femorotibial mechanical angle (FTMA) in 264 knees in
77 male and 55 female healthy volunteers aged 18 to 35 years (mean
26.2). We found the mean supine alignment to be a varus angle of
1.2° (standard deviation ( Knee alignment is different in different individuals and is dynamic
in nature, changing with different postures. This may have implications
for the assessment of alignment in TKA, which is achieved in non-weight-bearing conditions
and which may not represent the situation observed during weight-bearing. Cite this article:
