Kinematic Alignment of Failed Mechanically Aligned Total Knee Arthroplasty Restored Constitutional Limb Alignment and Improved Clinical Outcomes: A Case Report of 7 Patients

Round 1

Reviewer 1 Report

Provide clearly the objective of the work before methods

Conclusion should be rewritten. No findings reported

 

Author Response

Author’s response to reviewer #1

 

The authors would like to thank the reviewer for his detailed notes and revisions.

Appropriate changes have been made to respond to all reviewer’s revisions. They are highlighted in yellow throughout the manuscript.

We hope that our revisions are received well and that the manuscript remains befitting of publication in your esteemed journal.

Yours sincerely,

The authors.

 

 

Comment 1: Provide clearly the objective of the work before methods

 

Authors’ response: As suggested we clearly stated the objective of the work before methods as follows

 

The aim of this study was to report if revising MA TKA patients with MFI or stiffness into KA will restore native limb alignment, resolve MFI, improve range of motion, and impact patient-reported outcomes.

 

Comment 2: Conclusion should be rewritten. No findings reported

 

Authors’ response: As suggested we modified the conclusion as follows:

 

ABSTRACT CONCLUSION

 

In a limited series of patients, revision of stiff or unstable TKA from MA to KA resulted in improved range of motion by 30 degrees on averages, resolved instability without the use of constrained liners, improved clinical outcomes with a mean gain of 75 points on the KSS, and restored constitutional limb alignment within 2 degrees in all patients. As these short term results are promising, further study is warranted.

 

 

MANUSCRIPT CONCLUSION

 

In a limited series of patients, revision of stiff or unstable TKA from MA to KA resulted in improved range of motion by 30 degrees on averages, resolved instability without the use of constrained liners, improved clinical outcomes with a mean gain of 75 points on the KSS, and restored constitutional limb alignment within 2 degrees in all patients. As these short term results are promising, further study is warranted.

 

Reviewer 2 Report

This is a very nicely performed study, although small, and would consider including patient satisfaction/pain to make the paper stronger in conclusions to support complimentary to alignment/motion postop success.

Author Response

Author’s response to reviewer #2

 

The authors would like to thank the reviewer for his detailed notes and revisions.

Appropriate changes have been made to respond to all reviewer’s revisions. They are highlighted in yellow throughout the manuscript.

We hope that our revisions are received well and that the manuscript remains befitting of publication in your esteemed journal.

Yours sincerely,

The authors.

 

 

Comment 1: This is a very nicely performed study, although small, and would consider including patient satisfaction/pain to make the paper stronger in conclusions to support complimentary to alignment/motion postop success.

 

Authors’ response: As suggested patient satisfaction and pain score assessment were added in the methods section and in the results section as follows

 

METHODS

The pain was assessed using the visual analog scale (VAS). Patient satisfaction and complication rates were assessed at the last follow-up.

 

RESULTS

In all cases, the pain score was reported as improved compared to the pre-revision score (2.3 ± 1.8 vs 6.6 ± 0.8; p<0.001, respectively). Three patients reported being satisfied and four were very satisfied with their revision procedure.

 

 

 

Reviewer 3 Report

This is an interesting topic correctly handled. Methods are clear, language is adequate and it not require modifications. 

I think the article is suitable for publication on this Journal, and does not need further corrections.

Author Response

Author’s response to reviewer #3

 

The authors would like to thank the reviewer for his comments.

 

 

Comment 1: This is an interesting topic correctly handled.

Methods are clear, language is adequate and it not require modifications. 

I think the article is suitable for publication on this Journal, and does not need further corrections.

 

Authors’ response: No specific changes were asked.

However, the manuscript was slightly modified according to the comments of the other two reviewers.