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- Talk
- 19/05/2021
- UK
Patient Specific Alignment Navigated Balanced TKA Philosophy, Clinical Studies Outcome and Satisfaction
Description
This presentation by Mark Clatworthy discusses the innovative approach of patient-specific alignment navigated balanced total knee arthroplasty. Clatworthy begins by addressing the traditional method of total knee surgery, which relies on a mechanical alignment that presumes uniformity in knee anatomy, implying that every knee is treated the same, often resulting in non-anatomical cuts that do not respect the natural soft tissue envelope of the knee. This raises a pivotal question: Should every knee be aligned uniformly?
Over the past decade, the success of traditional neutral mechanical alignment has been increasingly scrutinized. Clatworthy highlights key studies, particularly from the Mayo Clinic, which reveal that knees aligned mechanically may perform poorly compared to slightly misaligned ones (three to six degrees). He cites Johan Bellemans’ theory of constitutional varus, suggesting that rigid adherence to neutral alignment can be detrimental to knee function.
To address these shortcomings, Clatworthy introduces his patient-specific alignment technique that respects individual anatomical variance. Key features include minimized reliance on soft tissue release to preserve the natural soft tissue configuration of the knee and the adoption of cutting-edge robotic technology for precise implantation of knee components. Clatworthy emphasizes the importance of a balanced, anatomical resurfacing approach that adapts to the patient's unique anatomical characteristics, ensuring that the joints function correctly throughout their range of motion.
Data from over a thousand knee surgeries using this technique illustrates improved outcomes in terms of function and patient satisfaction scores at two and five years post-surgery. Clatworthy provides compelling statistics showing a significant percentage of patients satisfied with pain relief and return to desired activities, alongside superior Oxford score outcomes compared to conventional methods and even total hip replacements.
Finally, he addresses concerns regarding femoral rotation, demonstrating robust evidence that variable rotations do not negatively impact outcomes, contrary to conventional beliefs about patient surgery technique. Clatworthy concludes that this patient-specific alignment approach using advanced navigation leads to better surgical outcomes, underlining the evolving understanding of knee arthroplasty that prioritizes individualized patient care.