What if knee replacement surgery started with the knee in front of you, not a textbook standard? That's the premise behind functional knee phenotyping, the topic of this episode with host Joaquin Moya-Angeler and guests Michael Hirschmann and Sebastien Lustig.
Rather than applying rigid mechanical alignment rules across the board, this approach asks surgeons to read each patient's unique anatomy and soft tissue behaviour – and to plan surgery around it. Hirschmann and Lustig walk through what that looks like in practice, from balancing soft tissue dynamics to using 3D imaging and robotic navigation to understand how a knee actually moves.
It's a shift that's still finding its footing in clinical practice – the guests are honest about the learning curve – but the potential upside for patient outcomes and satisfaction has both experts optimistic about where the field is headed.
Tune in for a grounded, expert look at one of the more significant shifts happening in TKA today.
Papers, books and resources discussed:
More about Stephen Howell: https://www.drstevehowell.com/for-physicians/
Leal-Blanquet, J., Haddad, F., Lustig, S., Bonnin, M., Van Hellemondt, G., Rivière, C., Pujol, O. and Hirschmann, M.T. (2026), Restoring the native knee or designing the ‘optimal prosthetic’: Alignment, phenotypes and AI-powered personalization in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc., 34: 800-803. https://doi.org/10.1002/ksa.70147
Andriollo L, Koutserimpas C, Gregori P, Vermue H, Hirschmann MT, Lustig S. Dynamic Alignment of the Knee (DyAK) Classification: Advancing Knee Evaluation in Robotic Arthroplasty. J Arthroplasty. 2026 Jul;41(7S1):S147-S154. doi: 10.1016/j.arth.2026.03.008. Epub 2026 Apr 1. PMID: 41945034: https://pubmed.ncbi.nlm.nih.gov/41945034/
jingle track (baby jean) provided by mobygratis
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