Article Sidebar

PDF (Tiếng Việt)
Published: 2025-08-29
Abstract Views: 0
Views PDF (Tiếng Việt): 0
DOI: https://doi.org/10.52852/tcncyh.v193i8.3797
Issue
Vol. 193 No. 8 (2025)
Section
Các bài báo
How to Cite
Năng, V. S. Q. ., Nam, V. T. ., Hiếu, P. T. ., Dũng, T. T. ., & Toàn, D. Đình . (2025). Effects of postoperative mechanical alignment on the clinical outcomes of total knee arthroplasty using patient-specific instruments. Journal of Medical Research, 193(8), 29-36. https://doi.org/10.52852/tcncyh.v193i8.3797

Effects of postoperative mechanical alignment on the clinical outcomes of total knee arthroplasty using patient-specific instruments

Vo Sy Quyen Nang, Vu Tu Nam, Pham Trung Hieu, Tran Trung Dung, Duong Dinh Toan

Main Article Content

Abstract

This prospective study aimed to evaluate clinical outcomes and analyze the impact of postoperative mechanical alignment of total knee arthroplasty (TKA) using 3D-printed patient-specific instrumentation (PSI). A total of 45 TKA cases were followed over a 12-months period. The mechanical axis of the lower limb was assessed using full-length computed tomography, with an average of 169.8° ± 2.6° preoperatively and 178.1° ± 1.3° postoperatively. Clinical outcomes were evaluated using the 2011 Knee Society Score (KSS) and the WOMAC score. The KSS improved significantly from 81.6 ± 16.3 preoperatively to 176.5 ± 10.6 post-operatively, while the WOMAC score decreased from 69.4 ± 9.9 to 19.5 ± 5.6. No postoperative complication was reported. Statistical analysis showed no significant correlation between the degree of postoperative mechanical axis deviation and clinical outcomes. Short-term follow-up results indicate that TKA using patient-specific instrumentation is a safe and effective surgical approach. 

Article Details

Keywords

total knee arthroplasty, mechanical align, PSI

References

1. Liu HX, Shang P, Ying XZ, et al. Shorter survival rate in varus-aligned knees after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. Aug 2016;24(8):2663-71. doi:10.1007/s00167-015-3781-7
2. Aunan E, Alhaug E, Schuller SG, et al. 3-dimensional computer tomography is more accurate than traditional long-leg radiographs in the planning and evaluation of coronal alignment in total knee arthroplasty: a prospective study on 121 knees. Acta Orthop. Oct 26 2023;94:530-536. doi:10.2340/17453674.2023.19695
3. Mannan A, Smith TO. Favourable rotational alignment outcomes in PSI knee arthroplasty: A Level 1 systematic review and meta-analysis. Knee. Mar 2016;23(2):186-90. doi:10.1016/j.knee.2015.08.006
4. Riviere C, Iranpour F, Auvinet E, et al. Mechanical alignment technique for TKA: Are there intrinsic technical limitations? Orthop Traumatol Surg Res. Nov 2017;103(7):1057-1067. doi:10.1016/j.otsr.2017.06.017
5. Wan XF, Yang Y, Wang D, et al. Comparison of Outcomes After Total Knee Arthroplasty Involving Postoperative Neutral or Residual Mild Varus Alignment: A Systematic Review and Meta-analysis. Orthop Surg. Feb 2022;14(2):177-189. doi:10.1111/os.13155
6. Miralles-Munoz FA, Gonzalez-Parreno S, Martinez-Mendez D, et al. A validated outcome categorization of the knee society score for total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. Apr 2022;30(4):1266-1272. doi:10.1007/s00167-021-06563-2
7. Pauzenberger L, Munz M, Brandl G, et al. Patient-specific instrumentation improved three-dimensional accuracy in total knee arthroplasty: a comparative radiographic analysis of 1257 total knee arthroplasties. J Orthop Surg Res. Dec 12 2019;14(1):437. doi:10.1186/s13018-019-1465-6
8. Remes V. CORR Insights(R): How do knee implants perform past the second decade? Nineteen- to 25-year followup of the Press-fit Condylar design TKA. Clin Orthop Relat Res. Jan 2015;473(1):141-2. doi:10.1007/s11999-014-3880-7
9. Long WJ, Bryce CD, Hollenbeak CS, et al. Total knee replacement in young, active patients: long-term follow-up and functional outcome: a concise follow-up of a previous report. J Bone Joint Surg Am. Sep 17 2014;96(18):e159. doi:10.2106/JBJS.M.01259
10. Parratte S, Pagnano MW, Trousdale RT, et al. Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements. J Bone Joint Surg Am. Sep 15 2010;92(12):2143-9. doi:10.2106/JBJS.I.01398
11. Abdel MP, Ollivier M, Parratte S, et al. Effect of Postoperative Mechanical Axis Alignment on Survival and Functional Outcomes of Modern Total Knee Arthroplasties with Cement: A Concise Follow-up at 20 Years. J Bone Joint Surg Am. Mar 21 2018;100(6):472-478. doi:10.2106/JBJS.16.01587
12. Matassi F, Pettinari F, Frascona F, et al. Coronal alignment in total knee arthroplasty: a review. J Orthop Traumatol. May 22 2023;24(1):24. doi:10.1186/s10195-023-00702-w
13. Blight TJ, Choong PFM. No consistent association between patient-reported outcome measures and coronal alignment following total knee arthroplasty: a narrative review. ANZ J Surg. Dec 2022;92(12):3176-3181. doi:10.1111/ans.18050
14. MacDessi SJ, Griffiths-Jones W, Harris IA, et al. Coronal Plane Alignment of the Knee (CPAK) classification. Bone Joint J. Feb 2021;103-b(2):329-337. doi:10.1302/0301-620x.103b2.Bjj-2020-1050.R1
15. Calliess T, Bauer K, Stukenborg-Colsman C, et al. PSI kinematic versus non-PSI mechanical alignment in total knee arthroplasty: a prospective, randomized study. Knee Surg Sports Traumatol Arthrosc. Jun 2017;25(6):1743-1748. doi:10.1007/s00167-016-4136-8