Author: Ishaan Jagota
Jagota, Ishaan, 2025 Bone and Soft Tissue Informed Preoperative Planning in Total Knee Arthroplasty, Flinders University, College of Science and Engineering
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Despite its success, up to 20% of Total Knee Arthroplasty (TKA) patients report dissatisfaction, often due to alignment strategies that neglect individual anatomy. Current tools like the Coronal Plane Alignment of the Knee (CPAK) system are limited, focusing predominantly on 2D coronal alignment while overlooking crucial soft tissue dynamics and 3D knee morphology.
This dissertation evaluated CPAK, confirming its limitations in capturing 3D joint variability. It also revealed that preoperative functional laxity assessments are better predictors of postoperative Patient-Reported Outcome Measures (PROMs) than intraoperative surgical laxity. To address these gaps, a novel "Distracted Alignment protocol" was developed. This framework uses a reliable joint distraction radiology protocol and a 3D-to-2D registration method to integrate both bony anatomy and soft tissue behaviour. The protocol generates patient-specific alignments that balance the knee in both extension and flexion, closely mirroring healthy knee morphology. This holistic approach offers a stronger foundation for advancing personalised TKA planning.
Keywords: Total knee arthroplasty, tka, distracted alignment, preoperative planning, coronal knee laxity, joint gaps, balance, stress radiograph
Subject: Biotechnology thesis
Thesis type: Doctor of Philosophy
Completed: 2025
School: College of Science and Engineering
Supervisor: Mark Taylor