Inverse Kinematic Alignment in Robot-Assisted Total Knee Arthroplasty: A Simplified Surgical Technique

Inverse kinematic alignment (iKA) is an emerging technique in total knee arthroplasty (TKA) that aims to restore the patients' native tibial joint line obliquity with femoral resections adjusted to balance the knee. By emphasizing joint line restoration and patient-specific balancing, iKA has gained interest as a potentially favorable alternative to traditional alignment techniques. This step-by-step surgical technique aims to outline the essential principles of iKA in robotic-assisted TKA. The method prioritizes an anatomic tibia resection and then a tensioner-based gap balancing technique to recreate natural kinematics. Since the technique is applicable to a wide range of patients and can be integrated to a variety of robotic platforms, iKA offers a promising pathway to standardize personalized alignment in TKA.