Targeting the neutral hip-to-calcaneus axis in kinematically aligned total knee arthroplasty is feasible with fewer alignment outliers for varus osteoarthritic patients

1. Bellemans J, Colyn W, Vandenneucker H, Victor J (2012) The

Chitranjan Ranawat award: is neutral mechanical alignment normal for all patients? The concept of constitutional varus. Clin

Orthop Relat Res 470:45–53

2. Chandler JT, Moskal JT (2004) Evaluation of knee and hindfoot

alignment before and after total knee arthroplasty: a prospective

analysis. J Arthroplast 19:211–216

3. Cho WS, Cho HS, Byun SE (2017) Changes in hindfoot alignment after total knee arthroplasty in knee osteoarthritic patients

with varus deformity. Knee Surg Sports Traumatol Arthrosc

25:3596–3604

4. Courtney PM, Lee GC (2017) Early outcomes of kinematic

alignment in primary total knee arthroplasty: a meta-analysis

of the literature. J Arthroplast 32(2028–2032):e2021

5. Desai SS, Shetty GM, Song HR, Lee SH, Kim TY, Hur CY

(2007) Effect of foot deformity on conventional mechanical axis

13

3888

deviation and ground mechanical axis deviation during single

leg stance and two leg stance in genu varum. Knee 14:452–457

6. Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: a

flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191

7. Gao ZX, Long NJ, Zhang SY, Yu W, Dai YX, Xiao C (2020)

Comparison of kinematic alignment and mechanical alignment

in total knee arthroplasty: a meta-analysis of randomized controlled clinical trials. Orthop Surg 12:1567–1578

8. Haraguchi N, Ota K, Tsunoda N, Seike K, Kanetake Y, Tsutaya

A (2015) Weight-bearing-line analysis in supramalleolar osteotomy for varus-type osteoarthritis of the ankle. J Bone Joint

Surg Am 97:333–339

9. Hess S, Moser LB, Robertson EL, Behrend H, Amsler F, Iordache E et al (2022) Osteoarthritic and non-osteoarthritic

patients show comparable coronal knee joint line orientations

in a cross-sectional study based on 3D reconstructed CT images.

Knee Surg Sports Traumatol Arthrosc 30:407–418

10. Hirschmann MT, Karlsson J, Becker R (2018) Hot topic: alignment in total knee arthroplasty-systematic versus more individualised alignment strategies. Knee Surg Sports Traumatol

Arthrosc 26:1587–1588

11. Hirschmann MT, Moser LB, Amsler F, Behrend H, Leclercq V,

Hess S (2019) Phenotyping the knee in young non-osteoarthritic

knees shows a wide distribution of femoral and tibial coronal

alignment. Knee Surg Sports Traumatol Arthrosc 27:1385–1393

12. Hirschmann MT, Moser LB, Amsler F, Behrend H, Leclerq V,

Hess S (2019) Functional knee phenotypes: a novel classification

for phenotyping the coronal lower limb alignment based on the

native alignment in young non-osteoarthritic patients. Knee Surg

Sports Traumatol Arthrosc 27:1394–1402

13. Hiyama S, Takahashi T, Takeshita K (2022) Kinematically

aligned total knee arthroplasty did not show superior patientreported outcome measures: an updated meta-analysis of randomized controlled trials with at least 2-year follow-up. J Knee

Surg 35:634–639

14. Howell SM, Howell SJ, Kuznik KT, Cohen J, Hull ML (2013)

Does a kinematically aligned total knee arthroplasty restore function without failure regardless of alignment category? Clin Orthop

Relat Res 471:1000–1007

15. Howell SM, Papadopoulos S, Kuznik KT, Hull ML (2013) Accurate alignment and high function after kinematically aligned TKA

performed with generic instruments. Knee Surg Sports Traumatol

Arthrosc 21:2271–2280

16. Hutt JR, LeBlanc MA, Masse V, Lavigne M, Vendittoli PA (2016)

Kinematic TKA using navigation: surgical technique and initial

results. Orthop Traumatol Surg Res 102:99–104

17. Ishii Y, Noguchi H, Sato J, Takahashi I, Ishii H, Ishii R et al

(2021) Alignment evaluation using different distal reference

points after total knee arthroplasty. J Orthop 25:186–190

18. Kamenaga T, Nakano N, Takayama K, Tsubosaka M, Takashima

Y, Kikuchi K et al (2021) Comparison of plantar pressure distribution during walking and lower limb alignment between modified

kinematically and mechanically aligned total knee arthroplasty. J

Biomech 120:110379

19. Kikuchi N, Kanamori A, Kadone H, Okuno K, Hyodo

K, Yamazaki M (2022) Radiographic analysis using the

13

Knee Surgery, Sports Traumatology, Arthroscopy (2023) 31:3880–3888

20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. hip-to-calcaneus line and its association with lower limb joint

kinetics in varus knee osteoarthritis. Knee 35:142–148

Kim JG, Suh DH, Choi GW, Koo BM, Kim SG (2021) Change

in the weight-bearing line ratio of the ankle joint and ankle joint

line orientation after knee arthroplasty and high tibial osteotomy

in patients with genu varum deformity. Int Orthop 45:117–124

MacDessi SJ, Griffiths-Jones W, Harris IA, Bellemans J, Chen DB

(2021) Coronal plane alignment of the knee (CPAK) classification. Bone Joint J 103-B:329–337

Matsumoto T, Hashimura M, Takayama K, Ishida K, Kawakami

Y, Matsuzaki T et al (2015) A radiographic analysis of alignment

of the lower extremities–initiation and progression of varus-type

knee osteoarthritis. Osteoarthritis Cartilage 23:217–223

Matsumoto T, Takayama K, Ishida K, Hayashi S, Hashimoto S,

Kuroda R (2017) Radiological and clinical comparison of kinematically versus mechanically aligned total knee arthroplasty.

Bone Joint J 99-B:640–646

Matsumoto T, Takayama K, Ishida K, Kuroda Y, Tsubosaka M,

Muratsu H et al (2020) Intraoperative soft tissue balance/kinematics and clinical evaluation of modified kinematically versus mechanically aligned total knee arthroplasty. J Knee Surg

33:777–784

Matsumoto T, Takayama K, Muratsu H, Matsushita T, Kuroda

R, Kurosaka M (2015) Semimembranosus release reduces tibial

internal rotation and flexion angle in cruciate-retaining total knee

arthroplasty. J Arthroplasty 30:1537–1541

Mullaji A, Shetty GM (2011) Persistent hindfoot valgus causes lateral deviation of weightbearing axis after total knee arthroplasty.

Clin Orthop Relat Res 469:1154–1160

Naylor BH, Seidman D, Scuderi GR (2021) Bridging the gap: the

influence of foot and ankle pathomechanics in total knee arthroplasty. J Am Acad Orthop Surg 29:e693–e701

Norton AA, Callaghan JJ, Amendola A, Phisitkul P, Wongsak

S, Liu SS et al (2015) Correlation of knee and hindfoot deformities in advanced knee OA: compensatory hindfoot alignment and

where it occurs. Clin Orthop Relat Res 473:166–174

Reilingh ML, Beimers L, Tuijthof GJ, Stufkens SA, Maas M, van

Dijk CN (2010) Measuring hindfoot alignment radiographically:

the long axial view is more reliable than the hindfoot alignment

view. Skeletal Radiol 39:1103–1108

Schelker BL, Nowakowski AM, Hirschmann MT (2022) What is

the “safe zone” for transition of coronal alignment from systematic to a more personalised one in total knee arthroplasty? A systematic review. Knee Surg Sports Traumatol Arthrosc 30:419–427

Tanaka T, Takayama K, Hashimoto S, Kanzaki N, Hayashi S,

Kuroda R et al (2017) Radiographic analysis of the lower limbs

using the hip-calcaneus line in healthy individuals and in patients

with varus knee osteoarthritis. Knee 24:1146–1152

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