EVALUATION OF THE EFFICACY OF KINEMATIC AND MECHANICAL ALIGNMENT IN PRIMARY TOTAL KNEE ARTHROPLASTY DURING THE EARLY POSTOPERATIVE PERIOD

Abstract

Mechanical alignment is widely accepted as a standard technique for total knee arthroplasty (TKA). However, approximately 20 % of patients remain dissatisfied with the outcomes. Recent studies suggest that an alternative method, known as kinematic alignment, could potentially improve functional outcomes and provide more rapid pain relief during the early postoperative period. Objective. To compare early postoperative clinical and functional outcomes of primary total knee arthroplasty performed using either kinematic or mechanical alignment. Methods. We prospectively analyzed the outcomes of 100 patients undergoing primary TKA, with 50 patients receiving mechanical alignment and 50 receiving kinematic alignment. Clinical assessments included pain measurement using the VAS, functional evaluation using the WOMAC, and knee range of motion (ROM). Assessments were conducted preoperatively, at 14 days, and 1.5 months postoperatively. Results. Analysis of key surgical parameters — including operation duration, intraoperative blood loss, and length of hospital stay — revealed no significant differences between the two groups. However, the requirement for additional ligament releases was significantly higher in the mechanical alignment group. According to WOMAC scores, the kinematic alignment group showed consistently better outcomes at all follow-up stages. At postoperative day 14, the kinematic alignment group had significantly better VAS pain scores and greater knee ROM compared to the mechanical alignment group (p < 0.05). However, by 1.5 months after surgery, the differences between the two groups were no longer statistically significant (p > 0.05). Conclusions. Kinematic alignment leads to superior early pain relief and faster functional recovery in the initial postoperative period compared to mechanical alignment. Nevertheless, differences in pain and function between both groups diminish by 1.5 months after surgery. These findings suggest the need for further studies with a longer follow-up (at least one year) to evaluate long-term outcomes and potential complications.