Fig. 2 | Scientific Reports

Fig. 2

From: Manual restricted kinematic alignment technique restores postoperative limb alignment in severe knee deformities

Fig. 2

Process flowchart of the decision-making protocol for manual rKA-TKA with modified STRT. The surgical protocol consists of the following five key steps: (a) Femoral resurfacing procedure, (b) Modified STRT for determining proximal medial tibial resection, (c) Decision-making for rKA- or urKA-TKA based on the lateral offset position of the extramedullary tibial guide relative to the tibiofibular joint, (d) Execution of rKA-TKA by repositioning the offset to align with the tibiofibular joint (approximately 3° varus), (e) Final angular adjustment through modification of lateral bearing thickness. rKA-TKA restricted kinematically aligned total knee arthroplasty, urKA-TKA unrestricted kinematically aligned total knee arthroplasty, STRT soft tissue-respecting technique.

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