Restricted Kinematic Alignment Leads to Uncompromised Osseointegration of Cementless Total Knee Arthroplasty

Description

In this presentation, Guillaume Laforest, a PGY4 student at the University of Montreal, discusses his article titled "Restricted Kinematic Alignment Leads to Uncompromised Osseointegration of Cementless Total Knee Arthroplasty." He outlines the high dissatisfaction rates among knee arthroplasty patients despite advancements in surgical techniques, highlighting that aseptic loosening is the leading cause of failure, particularly in younger and morbidly obese populations due to increased mechanical stress on implants.



Laforest critiques the traditional cemented fixation method, noting its gradual degradation and potential durability issues, and introduces cementless fixation as a compelling alternative that facilitates more durable biological fixation. The presentation examines the challenges of mechanical alignment, which standardizes knee alignment by altering native knee anatomy, in comparison to kinematic alignment, which focuses on preserving pre-arthritic knee anatomy with personalized adjustments.



Laforest presents a hypothesis that cementless implants can be safely combined with restricted kinematic alignment. He shares details from a study initiated in 2015 involving the first 100 cases of a novel implant technique, emphasizing the outcomes related to complications, revisions, and patient-reported satisfaction metrics. Findings show a low revision rate and encouraging functional scores with minimal modification to alignment angles, indicating a high rate of successful primary fixation.



Ultimately, Laforest concludes that restricted kinematic alignment can be effectively and safely used with cementless fixation in primary total knee arthroplasty, while acknowledging study limitations and anticipating further research to confirm long-term benefits.

DOI: 10.1302/3114-220797

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