ArticleOrthopaedic surgery2023
Kinematic Alignment May Reduce Opioid Consumption and Length of Stay Compared to Mechanically Aligned Total Knee Arthroplasty.
Article in Orthopaedic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical outcomes of restricted kinematic alignment versus mechanical alignment in total knee arthroplasty: a meta-analysis of randomized controlled trials.BMC musculoskeletal disorders · 2025Pooled it
- Mechanical versus kinematic alignment for total knee arthroplasty: a meta-analysis.Archives of orthopaedic and trauma surgery · 2025Pooled it
- Patellar tracking and patellar tilt in kinematic versus mechanical knees.Journal of experimental orthopaedics · 2026Article
- Robotic-Assisted Kinematically Aligned Total Knee Arthroplasty Demonstrated Early Rehabilitation and Select Mental Health-Related Quality of Life Improvements Compared to Conventional MA-TKA.Journal of clinical medicine · 2026Article
- Evolving Philosophies of Alignment in TKA: From Mechanical Uniformity to Personalised Harmony.Medicina (Kaunas, Lithuania) · 2026Review
- Kinematic alignment yields a reduced knee adduction moment and better range of motion compared to mechanical alignment: biomechanical considerations of a staged, bilateral total knee arthroplasty case.BMC musculoskeletal disorders · 2026Article
- Revision of Well-Fixed Mechanically-Aligned Total Knee Arthroplasty Using Kinematic Alignment for the Restoration of Joint Line Obliquity: Report of a Surgical Technique.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Impact of change in coronal plane alignment of knee (CPAK) classification on outcomes of robotic-assisted TKA.Arthroplasty (London, England) · 2024Article
- Methods of alignment in total knee arthroplasty, systematic review.Orthopedic reviews · 2024Article
- Definitions and consequences of current alignment techniques and phenotypes in total knee arthroplasty (TKA) - there is no winner yet.Journal of experimental orthopaedics · 2023Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePrevious studies have sought to determine the effects of total knee arthroplasty (TKA) using kinematic alignment (KA) versus mechanical alignment (MA) to reproduce the native knee alignment and soft tissue envelope for improved patient satisfaction. There are limited studies that compare acute perioperative outcomes between KA and MA patients as it pertains to pain-related opioid consumption and hospital length of stay (LOS). This study aims to compare early KA and MA in restoring function and rehabilitation after surgery to reduce hospitalization and opioid consumption.
methodsA retrospective review of 42 KA and 58 MA primary TKA patients performed by a single surgeon between 2020-2021 was conducted. Demographics were controlled between groups and radiographic measurements and functional outcomes were compared. Pain was evaluated with inpatient/outpatient morphine milligram equivalents (MME) and visual analogue scale (VAS) scores. Mobility was assessed using multiple measures by a physical therapist. Mean preoperative and 3-month postoperative flexion range of motion (ROM) were analyzed, and overall complications, LOS, and non-home discharge between groups compared. Continuous variables were compared using the Wilcoxon rank-sum test, and categorical variables were compared using the chi-square or Fisher exact test. Statistical significance was set at P < 0.05.
resultsKA patients had shorter LOS (1.8 vs 3.1 days) and less cumulative opioid requirements compared to MA patients (578 vs 1253 MME). On postoperative day 0, KA patients ambulated on average twice the distance of MA patients (20 vs 6.5 feet). KA patients had residual tibia component in varus (1.4° vs -0.3°), femoral component in valgus (-1.9° vs 0.2°), and valgus joint line obliquity compared with MA (-1.5° vs 0.2°). There were no significant differences between 3-month postoperative flexion arc motion, discharge destination, KOOS or SF-12 outcomes, and surgical complication rates between groups.
conclusionsBy restoring the native joint line obliquity and minimizing the frequency of ligament releases, KA for TKA may improve pain relief, early mobility, and decreased length of stay compared with traditional methods of establishing neutral limb axis by MA.
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