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BACKGROUND:The preceding study reported a 10-year follow-up of 222 kinematically aligned (KA) total knee arthroplasties (TKA) performed in 217 patients in 2007. As 35% of tibial components and 8% of limbs were in > 3° varus, the present study assessed whether this adversely affected reoperation, implant survival, and function at 16 years. METHODS:We retrospectively reviewed a single surgeon's private practice database to determine the patients who underwent reoperation as well as Forgotten Joint Score (FJS) and Oxford Knee Score. RESULTS:There were 7 patients who had a major reoperation (revision of a loose tibial component (n=2), and revision of well-fixed component due to stiffness (n=1), patella instability (n=1), pain (n=1), and infection (n=2)). There were 5 who had a minor reoperation that retained the components, and 91 patients (94 TKAs) died. Implant survivorship was 93% using reoperation for any reason as the endpoint. The median [interquartile range] Forgotten Joint and Oxford Knee scores were 88 [57 to 100] and 45 [39 to 48] points, respectively. CONCLUSIONS:The KA TKA had a 7% reoperation rate at 16 years follow-up, comparable to or lower than reports of mechanically aligned TKA, which supports the concept of the unrestricted version of kinematic alignment in which the patient's pre-arthritic alignment is fully restored regardless of deformity. Copyright © 2023. Published by Elsevier Inc.
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