Shatrov Jobe, Foissey Constant, Kafelov Moussa, Batailler Cécile, Gunst Stanislas, Servien Elvire, Lustig Sébastien
Department of Orthopaedics, Croix Rousse Hospital, University of Lyon 1, 69004 Lyon, France.
Sydney Orthopaedic Research Institute, Landmark Orthopaedics, St. Leonards, Sydney, NSW 2065, Australia.
J Pers Med. 2023 Jan 26;13(2):212. doi: 10.3390/jpm13020212.
Functional alignment (FA) is a novel philosophy to deliver a total knee arthroplasty (TKA) that respects individual bony and soft tissue phenotypes within defined limitations. The purpose of this paper is to describe the rationale and technique of FA in the valgus morphotype with the use of an image-based robotic-platform. For the valgus phenotype the principles are personalized pre-operative planning, reconstitution of native coronal alignment without residual varus or valgus of more than 3°, restoration of dynamic sagittal alignment within 5° of neutral, implant sizing to match anatomy, and achievement of defined soft tissue laxity in extension and flexion through implant manipulation within the defined boundaries. An individualized plan is created from pre-operative imaging. Next, a reproducible and quantifiable assessment of soft tissue laxity is performed in extension and flexion. Implant positioning is then manipulated in all three planes if necessary to achieve target gap measurements and a final limb position within a defined coronal and sagittal range. FA is a novel TKA technique that aims to restore constitutional bony alignment and balance the laxity of the soft tissues by placing and sizing implants in a manner that respects variations in individual anatomy and soft tissues within defined limits.
功能对线（FA）是一种全新的理念，用于在特定限制范围内实施全膝关节置换术（TKA），该理念尊重个体的骨骼和软组织表型。本文旨在描述使用基于图像的机器人平台在外翻形态类型中进行FA的基本原理和技术。对于外翻表型，其原则包括个性化的术前规划、重建自然冠状位对线，残余内翻或外翻不超过3°，在中立位5°范围内恢复动态矢状位对线，根据解剖结构选择合适尺寸的植入物，以及通过在规定边界内操作植入物，在伸直和屈曲时达到规定的软组织松弛度。根据术前影像学资料制定个性化方案。接下来，对伸直和屈曲时的软组织松弛度进行可重复且可量化的评估。然后，如有必要，在所有三个平面上调整植入物位置，以实现目标间隙测量，并使肢体最终位置处于规定的冠状位和矢状位范围内。FA是一种全新的TKA技术，旨在通过以尊重个体解剖结构和软组织在规定范围内变化的方式放置和选择植入物尺寸，恢复骨骼的自然对线并平衡软组织的松弛度。
