MODERN PHILOSOPHIES OF LOWER LIMB AXIS ALIGNMENT IN TOTAL KNEE REPLACEMENT



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Introduction. Knee arthroplasty is the main method of treating late stages of gonarthritis. According to the literature, 10 to 20% of patients remain dissatisfied with the surgical treatment. In order to improve the results of knee arthroplasty, various methods of lower limb axis alignment have been developed and offered for use for many decades.

Objective: to analyze modern methods of lower limb axis alignment in knee arthroplasty.

Materials and methods. The following databases were used to search for scientific papers: Sсopus, PubMed, the ResearchGate platform, and the eLIBRARY electronic scientific library. The search and analysis of publications was carried out in two languages: Russian and English.

Results and discussion. Each alignment principle has its own advantages and disadvantages. The most popular philosophies of axis alignment include: 1. Mechanical alignment, 2. Anatomical alignment - systemic methods that form a neutral axis; 3. Adjusted mechanical alignment, 4. Limited kinematic alignment – ​​hybrid techniques, 5. Kinematic alignment, 6. Functional alignment – ​​personalized techniques.

Conclusion. In connection with a more detailed study of the anatomy of the knee joint, its kinematics and the description of various knee phenotypes, a number of surgeons suggest performing hybrid and personalized alignments of the lower limb axis, taking into account the constitutional structure of the knee joint. At the same time, the literature data indicate that long-term results after knee arthroplasty are better or comparable when using the classical mechanical philosophy of axis alignment. Certainly, the modern alternative methods of limb axis alignment described in this work are aimed at improving the results of knee arthroplasty. However, due to insufficient information on the long-term survival rates of implants, time is needed to fully understand the feasibility of their use in the practice of an orthopedic surgeon.

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作者简介

Armen Daniliyants

ФГАОУ ВО "Российский университет дружбы народов имени Патриса Лумумбы", Москва, Россия

编辑信件的主要联系方式.
Email: armendts@mail.ru
ORCID iD: 0000-0001-6692-0975
SPIN 代码: 9880-2555
俄罗斯联邦

Georgy Airapetov

Email: airapetovga@yandex.ru
ORCID iD: 0000-0001-7507-7772
SPIN 代码: 7333-6640

Georgy Airapetov

Email: airapetovga@yandex.ru
ORCID iD: 0000-0001-7507-7772
SPIN 代码: 7333-6640

Nikolay Zagorodniy

Email: zagorodniy51@mail.ru

Nikolay Zagorodniy

Email: zagorodniy51@mail.ru

Dmitry Samkovitch

Email: dmitry.samkovitch@gmail.com

Konstantin Dzampaev

Email: kostya199921@gmail.com

Anjum Al Kafavin

Email: anjum.hasan@mail.ru

Akhmat Abdulaye

Email: dr.ahmataa@gmail.com

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