Current opinions about coronal plane alignment in total knee arthroplasty : A survey article

Purpose : To survey an audience of international knee surgeons about their current opinions on the analysis of coronal knee alignment and their objectives for postoperative alignment in total knee arthroplasty. Methods : Survey of 300 surgeons from 32 different countries with an audience response system allowing three possible answers being either a positive or negative answer or an abstention. Results : Surveyed surgeons perform rarely preoperative and postoperative full leg radiographs and evaluate radiological outcomes more with short films. The main trend in this survey was towards neutral mechanical alignment, however yarns alignment is acceptable in constitutional yarns patients. This residual yarns should be obtained through a femoral yarns cut rather than a tibial yarns cut. The valgus knee can remain in slight valgus but most of the correction will be performed at the femoral level. The main objective of postoperative alignment in TKA is a joint line parallel to the floor and a central load-bearing axis through the middle of the arthroplasty. Surgeons prefer unicompartmental arthroplasty more for themselves than for their patients in case of medial bone on bone arthritis. Conclusions : Neutral mechanical axis with a joint line parallel to the floor and a centrally running load bearing axis remains the central scope of the surveyed surgeons. Because of the literature on residual yarns it becomes more acceptable for the orthopaedic community to accept this type of outlier before aiming at a surgical correction.