Specific case consideration for implanting TKA with the Kinematic Alignment technique

• The Kinematic Alignment (KA) technique for total knee arthroplasty (TKA) is an alternative surgical technique aiming to resurface knee articular surfaces.

• The restricted KA (rKA) technique for TKA applies boundaries to the KA technique in order to avoid reproducing extreme constitutional limb/knee anatomies.

• The vast majority of TKA cases are straightforward and can be performed with KA in a standard (unrestricted) fashion.

• There are some specific situations where performing KA TKA may be more challenging (complex KA TKA cases) and surgical technique adaptations should be included.

• To secure good clinical outcomes, complex KA TKA cases must be preoperatively recognized, and planned accordingly.

• The proposed classification system describes six specific issues that must be considered when aiming for a KA TKA implantation.

• Specific recommendations for each situation type should improve the reliability of the prosthetic implantation to the benefit of the patient.

• The proposed classification system could contribute to the adoption of a common language within our orthopaedic community that would ease inter-surgeon communication and could benefit the teaching of the KA technique. This proposed classification system is not exhaustive and will certainly be improved over time.

Cite this article: EFORT Open Rev 2021;6:881-891. DOI: 10.1302/2058-5241.6.210042