Effect of coronal alignment on 10-year survivorship of a single contemporary total knee arthroplasty

Meagan E. Tibbo, Afton K. Limberg, Kevin I. Perry, Mark W. Pagnano, Michael J. Stuart, Arlen D. Hanssen, Matthew P. Abdel

Research output: Contribution to journalArticlepeer-review


Debate remains regarding the utility of mechanical axis alignment as a predictor of durability after total knee arthroplasty (TKA). Our study aimed to assess the effects of coronal alignment on implant durability, clinical outcomes, and radiographic results with a single fixed-bearing TKA design. All patients undergoing primary cemented TKA of a single design (Stryker Triathlon) from 2005–2007 with >10 years of follow-up and available pre-operative and post-operative hip–knee–ankle radiographs were included (n = 89). Radiographs were measured to determine coronal alignment and assessed for loosening. Mean preoperative mechanical axis alignment was 6 6.7 (varus, range, 1623), while mean post-operative alignment was 1  2.7 (varus, range, 315). The aligned group was defined as knees with a post-operative mechanical axis of 0  3 (n = 73) and the outlier group as those outside this range (n = 16). No patients underwent revision. Ten-year survivorship free from any reoperation was 99% and 100% in the aligned and outlier groups, respectively (p = 0.64). Knee Society scores improved significantly in both groups (p < 0.001) and did not differ at final follow-up (p = 0.15). No knees demonstrated radiographic evidence of loosening. Post-operative mechanical axis alignment within 3 of neutral was not associated with improved implant durability, clinical outcomes, or radiographic results at 10 years following primary TKA.

Original languageEnglish (US)
Article number142
Pages (from-to)1-9
Number of pages9
JournalJournal of Clinical Medicine
Issue number1
StatePublished - Jan 2021


  • Coronal alignment
  • Mechanical axis
  • Survivorship
  • Total knee arthroplasty

ASJC Scopus subject areas

  • General Medicine


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