Functional outcomes of kinematic alignment total knee arthroplasty in Indian patients: a retrospective cohort study

Abstract

Background: Kinematic alignment (KA) in total knee arthroplasty (TKA) aims to restore the pre-arthritic anatomy of the knee and may offer particular benefit to Indian patients, in whom constitutional varus is common. However, functional outcome data on KA TKA in Indian populations remain limited. This study aimed to assess the functional outcomes of KA TKA in Indian patients. Methods: This retrospective cohort study included 75 patients who underwent TKA at a single centre in India between January 2018 and August 2019. Functional outcomes were evaluated using the Oxford knee score (OKS) and the visual analogue scale (VAS) for pain at baseline and at 3, 6 and 12 months postoperatively. OKS values were further categorised. The Wilcoxon signed-rank test was used to compare follow-up scores with baseline, with significance set at p<0.05. Results: The cohort comprised 57 females (76%) and 18 males (24%), with a mean age of 66.75±6.95 years. The mean OKS improved from 18.6±0.87 at baseline to 50.5±1.19 at 12 months (p<0.001), with all patients reaching the ‘excellent’ category by the first follow-up. The mean VAS score fell from 5.4±0.49 to 1.0±0.00 at 12 months, an 81.4% reduction (p<0.001). Conclusions: KA in TKA produced significant and sustained improvements in function and pain relief in Indian patients, supporting its feasibility in this population. Larger, multicentre studies are warranted to confirm these findings.