title: Anatomic Versus Mechanically Aligned Total Knee Arthroplasty for Unicompartmental Knee Arthroplasty Revision.
abstract: OBJECTIVE
  The purpose of this study was to compare the intra-operative benefits and the clinical outcomes from kinematic or mechanical alignment for total knee arthroplasty (TKA) in patients undergoing revision of failed unicompartmental kneel arthroplasty (UKA) to TKA.
  
  
  METHODS
  Ten revisions were performed with a kinematic alignment technique and 11 with a mechanical alignment. Measurements of the hip-knee-ankle angle (HKA), the lateral distal femoral angle (LDFA), and the medial proximal tibial angle (MPTA) were performed using long-leg radiographs. The need for augments, stems, and constrained inserts was compared between groups. Clinical outcomes were compared using the WOMAC score along with maximum distance walked as well as knee range of motion obtained prior to discharge. All data was obtained by a retrospective review of patient files.
  
  
  RESULTS
  The kinematic group required less augments, stems, and constrained inserts than the mechanical group and thinner polyethylene bearings. There were significant differences in the lateral distal femoral angle (LDFA) and the medial proximal tibial angle (MPTA) between the two groups (p<0.05). The mean WOMAC score obtained at discharge was better in the kinematic group as was mean knee flexion. At last follow up of 34 months for the kinematic group and 58 months for the mechanical group, no orthopedic complications or reoperations were recorded.
  
  
  CONCLUSIONS
  Although this study has a small patient cohort, our results suggest that kinematic alignment for TKA after UKA revision is an attractive method. Further studies are warranted.
authors: Maisonneuve-Rosemont Hospital, Department of Surgery, University of Montreal, Montreal, Quebec, Canada; Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
authors: Panagiota
authors: P
authors: Toliopoulos
authors: Maisonneuve-Rosemont Hospital, Department of Surgery, University of Montreal, Montreal, Quebec, Canada.
authors: Marc-Andre
authors: MA
authors: LeBlanc
authors: Maisonneuve-Rosemont Hospital, Department of Surgery, University of Montreal, Montreal, Quebec, Canada.
authors: Jonathan
authors: J
authors: Hutt
authors: Maisonneuve-Rosemont Hospital, Department of Surgery, University of Montreal, Montreal, Quebec, Canada; Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
authors: Martin
authors: M
authors: Lavigne
authors: Maisonneuve-Rosemont Hospital, Department of Surgery, University of Montreal, Montreal, Quebec, Canada.
authors: Francois
authors: F
authors: Desmeules
authors: Maisonneuve-Rosemont Hospital, Department of Surgery, University of Montreal, Montreal, Quebec, Canada; Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
authors: Pascal-Andre
authors: PA
authors: Vendittoli
keywords: Kinematic alignment; Mechanical alignment; Osteoarthritis revision surgery; Total knee arthroplasty; Unicompartmental knee revision