title: Alignment and fixation in total knee arthroplasty: changing paradigms.
abstract: Many aspects of total knee arthroplasty have changed since its inception. Modern prosthetic design, better fixation techniques, improved polyethylene wear characteristics and rehabilitation, have all contributed to a large change in revision rates. Arthroplasty patients now expect longevity of their prostheses and demand functional improvement to match. This has led to a re-examination of the long-held belief that mechanical alignment is instrumental to a successful outcome and a focus on restoring healthy joint kinematics. A combination of kinematic restoration and uncemented, adaptable fixation may hold the key to future advances.
authors.affiliation: University College London Hospitals, 235 Euston Road, London NW1 2BU, UK.
authors.forename: S
authors.initials: S
authors.lastname: Oussedik
authors.affiliation: Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Abdel
authors.affiliation: Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Cross
authors.affiliation: University College London Hospitals, 235 Euston Road, London NW1 2BU, UK.
authors.forename: F S
authors.initials: FS
authors.lastname: Haddad
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods*; D001696:Biomechanical Phenomena; D006801:Humans; D007592:Joint Diseases / Q000517:prevention & control* / Q000601:surgery; D007719:Knee Joint / Q000502:physiology* / Q000601:surgery; D007720:Knee Prosthesis; D011183:Postoperative Complications / Q000517:prevention & control* / Q000601:surgery; D011474:Prosthesis Design; D020127:Recovery of Function; D012086:Reoperation; D014102:Torsion Abnormality / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D054159:Torsion, Mechanical
keywords: Knee arthoplasty; alignment; fixation; kinematic alignment; uncemented