Precision joint alignment for total knee replacement

Knee replacements are a routine procedure, which help to relieve the pain caused by osteoporosis, osteoarthritis and other joint diseases. Around 80,000 knee arthroscopies are carried out in the UK every year with the number set to grow as the population ages. The quality of the outcome is highly dependent on how the new knee is aligned to distribute the strain. Current methods for aligning the implant during surgery are complex and can be difficult to reproduce. Oxford researchers have developed a surgical tool capable of accurately and reproducibly aligning the joint during surgery, resulting in better surgical outcomes.

Total knee arthroplasty

Knee arthroplasty, the process of replacing a damaged knee with an artificial joint, is considered to be a routine procedure, with the new joints lasting up to 20 years. Generally, patients undergoing knee replacements are aged between 60-80 and the most common underlying cause of the damage is osteoarthritis. In the UK, around 80,000 knee replacements are carried out each year and with an ever-ageing population, this number is only set to rise. In fact, in the US, the demand for these procedures is predicted to rise over 600% by 2030.

Results hinge on alignment

A key step in the surgical process is aligning the new joint appropriately to correctly distribute the strain across the joint. Incorrect alignment can lead to a ligament misbalance, a cause of up to 20% of patients being unhappy with their outcome. Recently surgeons have been moving away from classical 2D mechanical alignment to employ a more complex, 3D kinematic alignment method. The kinematic method gives better outcomes as is more patient-specific, however it is difficult to implement and often requires the use of patient-specific surgical guides.

Simplified alignment

Surgeons based at the world-renowned Nuffield Orthopaedic Centre, University of Oxford, have developed a surgical device capable of simply aligning the new knee in a way that is sympathetic to normal ligament function. By referencing the femoral implant, it can give accurate and reproducible alignment.

We believe the benefits of this device to be as follows:

  • Simple to operate
  • Accurate and reproducible alignment
  • Potential applications in other joint arthroplasties
  • Can be adapted to allow for conventional implant positioning


Oxford University Innovation Ltd. has filed a priority patent application, which covers this technology and is seeking partners to aid in its exploitation.

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