Yamamoto Takao, Fukushima Shigenobu, Toyono Shuji, Miyaji Takahiro, Nakajima Taku, Wanezaki Yoshihiro, Ito Takashi
Department of Orthopedic Surgery Yamagata Prefectural Shinjo Hospital Shinjo-shi Yamagata Japan.
Artificial Joint Center Yamagata Saisei Hospital Yamagata Japan.
J Exp Orthop. 2025 May 12;12(2):e70264. doi: 10.1002/jeo2.70264. eCollection 2025 Apr.
This study aimed to evaluate the 2-year post-operative results of the unrestricted kinematic alignment technique in total knee arthroplasty (TKA) among Japanese patients and understand the potential benefits of this technique.
In total, 207 patients who underwent kinematic alignment in TKA for knee osteoarthritis between 2019 and 2021 were retrospectively reviewed. After applying the exclusion criteria, 164 knees remained for analysis (130 and 34 knees from female and male patients, respectively). The average age and body mass index were 74.5 ± 8.0 years and 26.4 ± 4.1 kg/m, respectively. Radiographic measurements were conducted preoperatively and post-operatively, while clinical evaluations-including knee extension, flexion angles, muscle strength, gait patterns and Knee Society scores (patient satisfaction and function)-were performed preoperatively, 1 year post-operatively and 2 years post-operatively. Statistical analysis was used to determine interobserver reliability and compare the preoperative and post-operative values. Radiographic evaluations were analyzed using a paired Student's test, while clinical evaluations were analyzed using one-way ANOVA followed by a Tukey-Kramer multiple comparison test. Statistical significance was set at < 0.05.
After surgery, statistically significant improvements were observed in both knee extension and flexion angles, as well as muscle strength ( < 0.01). Two years after surgery, the rates of independent indoor walking and stair climbing were 89.6% and 58.9%, respectively. Additionally, the Knee Society Scores (patient satisfaction and function) significantly improved compared with the preoperative status ( < 0.01). Complications were minimal; revision surgery was not required.
In Japanese patients, kinematic alignment in TKA demonstrated significant improvements and promising outcomes over 2 years. Although alignment characteristics prior to arthritis may vary due to ethnic differences, this method-designed to replicate patient-specific alignments-is considered to have achieved favourable outcomes by tailoring to individual alignments. Further research comparing kinematic alignment with conventional alignment techniques could provide more valuable insights.
Level III.
本研究旨在评估日本患者全膝关节置换术（TKA）中无限制运动学对线技术的术后2年结果，并了解该技术的潜在益处。
回顾性分析了2019年至2021年间因膝关节骨关节炎接受TKA运动学对线的207例患者。应用排除标准后，剩余164个膝关节用于分析（女性和男性患者分别为130个和34个膝关节）。平均年龄和体重指数分别为74.5±8.0岁和26.4±4.1kg/m²。术前和术后进行影像学测量，同时在术前、术后1年和术后2年进行临床评估，包括膝关节伸展、屈曲角度、肌肉力量、步态模式和膝关节协会评分（患者满意度和功能）。采用统计分析确定观察者间的可靠性，并比较术前和术后值。影像学评估采用配对t检验分析，临床评估采用单因素方差分析，随后进行Tukey-Kramer多重比较检验。统计学显著性设定为P<0.05。
术后，膝关节伸展和屈曲角度以及肌肉力量均有统计学意义的改善（P<0.01）。术后2年，独立室内行走和爬楼梯的比率分别为89.6%和58.9%。此外，与术前状态相比，膝关节协会评分（患者满意度和功能）显著改善（P<0.01）。并发症极少；无需翻修手术。
在日本患者中，TKA的运动学对线在2年内显示出显著改善和良好结果。尽管由于种族差异，关节炎之前的对线特征可能有所不同，但这种旨在复制患者特定对线的方法被认为通过根据个体对线进行调整而取得了良好结果。比较运动学对线与传统对线技术的进一步研究可能会提供更有价值的见解。
III级。
