Coronal alignment correlates with outcome after total knee arthroplasty: five-year follow-up of a randomized controlled trial.

In a prospective randomized control trial comparing computer-assisted vs conventional total knee arthroplasty, we previously reported that patients with coronal alignment within 3° of neutral had superior international knee society and Short-Form 12 (SF-12) physical scores at 6 weeks, 3 months, 6 months, and 12 months after surgery. Computer-assisted total knee arthroplasty achieved greater accuracy in implant alignment, and this correlated with better knee function and quality of life. At 5 years, 90 of 111 patients assessed in our original study were reviewed. Coronal alignment within 3° of neutral continued to be correlated with superior International Knee Society and SF-12 scores. Coronal alignment greater than 3° was associated with a significant decline in SF-12 mental health scores.