SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016
Shorter survival rate in varus-aligned knees after total knee arthroplasty.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- The evolution of robotic systems for total knee arthroplasty, each system must be assessed for its own value: a systematic review of clinical evidence and meta-analysis.Archives of orthopaedic and trauma surgery · 2023Pooled it
- No significant difference in early clinical outcomes of custom versus off-the-shelf total knee arthroplasty: a systematic review and meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- Comparison of Outcomes After Total Knee Arthroplasty Involving Postoperative Neutral or Residual Mild Varus Alignment: A Systematic Review and Meta-analysis.Orthopaedic surgery · 2022Pooled it
- No advantage with navigated versus conventional mechanically aligned total knee arthroplasty-10 year results of a randomised controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Trial
- Robotic-assisted TKA leads to a better prosthesis alignment and a better joint line restoration as compared to conventional TKA: a prospective randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Trial
- Accuracy of different navigation systems for femoral and tibial implantation in total knee arthroplasty: a randomised comparative study.Archives of orthopaedic and trauma surgery · 2021Trial
- Posterior Osteophyte Resection from the Medial Femoral Condyle Increases Medial Gap of Extension and Mid-Flexion in Total Knee Arthroplasty.Clinics in orthopedic surgery · 2026Article
- The Effect of the Coronal Alignment of Extension Stem on Component Displacement and Stress During Total Knee Arthroplasty: A Finite Element Study.Orthopaedic surgery · 2026Article
- Quantifying potential leg axis alteration from extramedullary tibial guide malalignment in total knee arthroplasty: a computer simulation.BMC musculoskeletal disorders · 2026Article
- Is technological-assisted leg axis alignment reliable in total knee arthroplasty with varus-valgus deformities?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Lateral Instability 13 Years After Kinematically Aligned Total Knee Arthroplasty.Arthroplasty today · 2025Article
- The influence of the number of postoperative radiological outliers on the survival and clinical outcome of total knee arthroplasty.Journal of clinical orthopaedics and trauma · 2025Article
- Total knee replacement with an accelerometer-based, hand-held navigation system improves knee alignment: reliable in all patients.Archives of orthopaedic and trauma surgery · 2024Article
- Comparison of Outcomes in Obese Patients after Total Knee Arthroplasty with Neutral or Mild Varus: A Retrospective Study with 8-Year Follow-Up.Orthopaedic surgery · 2024Article
- Comparison of Clinical and Radiological Outcomes of Total Knee Arthroplasty in Osteoarthritic Patients.Cureus · 2024Article
- A Retrospective Study to Compare Patient Outcomes from Standard Total Knee Arthroplasty (TKA) versus Navigation-Guided Arthroplasty Using the Brainlab Software-Guided Surgical System at a Center in Hebei Province January 2021 to July 2023.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
- Two- and three-dimensional evaluations following handheld robot-assisted total knee arthroplasty.Journal of robotic surgery · 2024Article
- Aseptic survival of the 1.5-stage exchange arthroplasty for periprosthetic joint infection was acceptable when using an autoclaved femoral component and a new polyethylene insert.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- 3-dimensional computer tomography is more accurate than traditional long-leg radiographs in the planning and evaluation of coronal alignment in total knee arthroplasty: a prospective study on 121 knees.Acta orthopaedica · 2023Article
- Outcomes of cruciate-retaining total knee arthroplasty for osteoarthritis with severe varus deformity.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeOne long-held tenet of total knee arthroplasty (TKA) is that post-operative neutral limb alignment promotes implant durability. Recently, the concept of generic safe zone (0° ± 3°) has been challenged. This meta-analysis aimed to evaluate whether neutral alignment was superior to malalignment in long-term survival of TKAs.
methodsThe MEDLINE, Embase, Cochrane Library, China National Knowledge Infrastructure, Wan Fang Chinese Periodical, Google and reference lists of all the included studies were searched. Of the 1512 studies initially identified, ten met the eligibility criteria, including eight case-control studies and two cohort trials. Relative risks of implant failure were compared between post-operative neutrally aligned and malaligned knees.
resultsPost-operative malalignment showed higher failure rate of knee implants compared with neutral alignment (95 % CI 1.00-1.88, P = 0.05). Failure rate in knees with varus alignment was significantly higher than with neutral alignment (95 % CI 1.07-2.55, P = 0.02). There was no significant difference in the likelihood of implant failure between knees with valgus and neutral alignment (95 % CI 0.78-2.41, n.s.). No significant difference of failure rate was noted between neutral alignment and malalignment for fixed-bearing prothesis (95 % CI 0.94-1.95, n.s.) or rotating-platform prothesis (95 % CI 0.75-2.73, n.s.). There was no significant difference of failure rate between knees with neutral alignment and malalignment for studies with a mean follow-up of more than 10 years (95 % CI 0.81-2.01, n.s.) or studies using long-leg weight-bearing radiographs (95 % CI 0.79-1.79, n.s.).
conclusionsPost-operative varus alignment results in shorter survival rate after TKA. Not only neutral limb alignment but also the valgus alignment promotes implant durability. Neutral or valgus alignment rather than varus alignment is essential to achieve long-term survival of TKAs and patient satisfaction. LEVEL OF EVIDENCE: III.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.