Technik des Balancings durch Knochenschnitte

Abstract

Kinematic alignment means a surgical technique that focuses on intraarticular balance and laxity and takes into consideration the prearthritic state of the knee joint. The aim of kinematic alignment is a constitutionally aligned joint space line and balanced tension of the soft tissue covering. By avoiding the proximalization of the joint line and the release of the ligaments, the risk of destabilization of the original physiology of the joint is reduced. After resections and recuts of the distal femur, a natural distal femoral joint line in full extension and the posterior line in 90° should be maintained or restored. Therefore, the flexion-extension axis of the femur, around which the knee joint moves, does not change. The principle of KA unequivocally requires the distal femoral cut to be performed before resection of the posterior femoral condyles. The result is a natural knee joint alignment that approximately replicates the anatomy of the femoral and tibial axes. Release of the ligaments is rarely required and all necessary adjustments are usually made using bone recuts.