Written by Dr Charles Rivière for Doctify

Joint replacements for hips and knees was successfully introduced in the 20th century. In order to prevent implant fixation failure and accelerated polyethylene wear, it was initially recommended (conventional technique) that implants were positioned in a ‘biomechanically friendly’ way, which disregarded most of the individual patient anatomy.

While those initial surgical techniques made for popular and clinically successful total joint replacements, many complications have remained, most notably the functional limitations after knee replacement and the persistence of frequent instability after hip replacement.

In response to those complications, many improvements were developed in the field of joint replacement over the last few decades, moving away from these conventional methods of positioning to more personalized techniques, namely the kinematic alignment (KA) technique.

KA technique for total joint replacement aim at precisely restoring the individual joint anatomy for a better balance of the surrounding soft tissue; regarding the hip, KA technique for hip replacement also consider the spine-hip relation in order to optimised the acetabular component positioning.

KA technique is now made possible because technology enables higher surgical precision and wear resistance of modern implants has significantly improved. Restoring the patient-specific anatomy, balance, and joint motion enables to reach better clinical outcomes of the prosthetic joint.

Current evidence has shown this personalized technique performs better early on than the conventional technique for knee replacement. Few high-quality scientific studies have shown the KA prosthesis to provide faster recovery, better functional outcomes, lower complication, a more physiologic feeling of the prosthetic joint, and higher satisfaction compared to conventional prosthesis up until two years of follow-up.

Charles, in collaboration with his MSK Lab team (Imperial College London) and some of his close colleagues, pioneered the KA technique for total hip and partial knee replacements and contributes to the development of the technique for total knee replacement; also he’s travelling the world to present its research and is progressively gaining international recognition.

 


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