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Coronal Alignment After Total Knee Arthroplasty: A Victim of Procrustes Syndrome?
179
Conclusion
As noted by Tew and Waugh in 1985, although
coronal alignment is surely a factor in the
outcome of TKA, it may not be the most
important factor and may serve to compound
failure from other causes [49]. Other technical
factors, such as sagittal and rotational alignment,
joint line restoration, and soft tissue balance all
influence the final outcome. The ideal alignment
for patient function and prosthesis longevity
may in fact be different. If so, advances in
materials technology may allow for implant
survival in a non-optimal mechanical environ
ment.Whilstmild residual global varus deformity
may not negatively impact outcomes, it is
important to avoid varus of the tibial component
and valgus of the femoral component.
Fig. 1: Asymmetrical
distal femoral cut
required to correct
varus of femoral
origin. To balance
the extension gap
requires
internal
rotation
of
the
femoral component.
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