Reoperation, Implant Survival, and Clinical Outcome After Kinematically Aligned Total Knee Arthroplasty: A Concise Clinical Follow-Up at 16 Years

Background: The preceding study reported a 10-year follow-up of 222 kinematically aligned total knee arthroplasties (TKA) performed in 217 patients in 2007. As 35% of tibial components and 8% of limbs were in >3 degrees varus, the present study assessed whether this adversely affected reoperation, implant survival, and function at 16 years. Methods: We retrospectively reviewed a single surgeon's private practice database to determine the patients who underwent reoperation as well as Forgotten Joint Score and Oxford Knee Score. Results: There were 7 patients who had a major reoperation (revision of a loose tibial component [n = 2], and revision of well-fixed component due to stiffness [n = 1], patella instability [n = 1], pain [n = 1], and infection [n = 2]). There were 5 who had a minor reoperation that retained the components, and 91 patients (94 TKAs) died. Implant survivorship was 93% using reoperation for any reason as the endpoint. The median (interquartile range) Forgotten Joint and Oxford Knee scores were 88 (57 to 100) and 45 (39 to 48) points, respectively. Conclusion: The kinematically aligned TKA had a 7% reoperation rate at 16 years follow-up, comparable to or lower than reports of mechanically aligned TKA, which supports the concept of the unrestricted version of kinematic alignment in which the patient's prearthritic alignment is fully restored regardless of deformity. (c) 2023 Elsevier Inc. All rights reserved.