Restricted Kinematic alignment (rKA) follows the same goals as KA but reproduce the constitutional knee anatomy of the patient within a safe range. Its fundamentals are based on sound comprehension of lower limb anatomy variation. There are five principles describing rKA: (1) Combined lower limb coronal orientation should be ± 3◦ of neutral; (2) Joint line orientation coronal alignment should be within ± 5◦ of neutral; (3) Natural knee’s soft tissues tension/ laxities should be preserved/restored; (4) Femoral anatomy preservation is prioritized; (5) The unloaded/most intact knee compartment should be resurfaced and used as the pivot point when anatomical adjustment is required. An algorithm was developed to facilitate the decision-making. Pascal-André Vendittoli, started to promote the technique in 2011. This technique requires radiographic pre op planning and patient specific instruments or intra operative precision tools like surgical navigation or robotic assistance.
rKA with computer navigation
rKA with Personalized Instruments (PSI)