Description
The presentation delivered by Charles Riviere discusses the kinematic alignment (KA) technique for total knee arthroplasty, contrasting it with the more traditional mechanical alignment (MA) method. Riviere emphasizes that while MA makes all knee implants uniform, KA aims to restore individual knee anatomy and soft tissue balance, highlighting the importance of tailored surgical techniques. He explains that KA is not merely an adjustment to MA; it is a distinct surgical approach requiring specific training. Riviere details the procedural aspects of KA, discussing the necessity of manual instrumentation or technological assistance, particularly in cases of extreme anatomy.
The presentation underscores the reproducibility of the KA technique, particularly with manual instrumentation, and emphasizes the ease of pre-operative planning and intra-operative checks. Riviere elaborates on the importance of verifying cuts made during surgery to ensure accuracy relative to the intended implant size. He introduces the concept of restricted KA (rKA), a variation that adjusts the kinematic alignment for unique anatomical considerations, linking technology to this process.
Moreover, Riviere mentions the Montréal Protocol for restricted KA developed by Pascal in Italy, which sets specific limits for alignment angles to maintain a balance between biomechanical integrity and the functionality of the joint. Following a stepwise approach for knee implantation, Riviere illustrates techniques for precise cuts in both the femur and tibia, offering tips to maintain anatomical references crucial for successful implantation. Finally, he concludes by asserting that the KA technique is more physiological and reproducible than MA, suggesting potential advantages for patients undergoing this procedure.