Evidence map›Paper›PMID 27120192›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017

PSI kinematic versus non-PSI mechanical alignment in total knee arthroplasty: a prospective, randomized study.

Tilman Calliess, Kamil Bauer, Christina Stukenborg-Colsman, Henning Windhagen, Stefan Budde, Max Ettinger

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03196011 (A Prospective, Randomised, Controlled Study of the Outcomes and Cost Effectiveness of Triathlon CR Knee Replacement System), which is not on this map. Cited by 111 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
111citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT03196011 naactive not recruitingnot on this mapstarted 2018, after this paper: background citation

A Prospective, Randomised, Controlled Study of the Outcomes and Cost Effectiveness of Triathlon CR Knee Replacement System: Traditional Technique Versus Alternative Alignment Method.

TypeinterventionalSponsorRoyal Devon and Exeter NHS Foundation TrustRan2018 to 2025Enrolled126ConditionsOsteo Arthritis KneeArmsTKR with mechanical alignment method, TKR with alternative alignment method
3 · Its place in the literature

Who cites it

111 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  8. Similar results with kinematic and mechanical alignment applied in total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020
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  9. Kinematic alignment is a possible alternative to mechanical alignment in total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017
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51 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Tilman CalliessDepartment of Orthopedic Surgery, Hannover Medical School, Anna-v.Borries-Str.1-7, 30625, Hannover, Germany.
Kamil BauerDepartment of Orthopedic Surgery, Hannover Medical School, Anna-v.Borries-Str.1-7, 30625, Hannover, Germany.
Christina Stukenborg-ColsmanDepartment of Orthopedic Surgery, Hannover Medical School, Anna-v.Borries-Str.1-7, 30625, Hannover, Germany.
Henning WindhagenDepartment of Orthopedic Surgery, Hannover Medical School, Anna-v.Borries-Str.1-7, 30625, Hannover, Germany.
Stefan BuddeDepartment of Orthopedic Surgery, Hannover Medical School, Anna-v.Borries-Str.1-7, 30625, Hannover, Germany.
Max EttingerDepartment of Orthopedic Surgery, Hannover Medical School, Anna-v.Borries-Str.1-7, 30625, Hannover, Germany. Max@ettinger.info.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeKinematic alignment in TKA is supposed to restore function by aligning the components to the premorbid flexion-extension axis instead of altering the joint line and natural kinematic axes of the knee. The purpose of this study was to compare mechanically aligned TKA to kinematic alignment.

methodsIn this study, 200 patients underwent TKA and were randomly assigned to 2 groups: 100 TKAs were performed using kinematic alignment with custom-made cutting guides in order to complete cruciate-retaining TKA; the other 100 patients underwent TKA that was manually performed using mechanical alignment. The WOMAC and combined Knee Society Score (KSS), as well as radiological alignment, were determined as outcome parameters at the 12-month endpoint.

resultsWOMAC and KSS significantly improved in both groups. There was a significant difference in both scores between groups in favour of kinematic alignment. Although the kinematic alignment group demonstrated significantly better overall results, more outliers with poor outcomes were also seen in this group. A correlation between post-operative alignment deviation from the initial plan and poor outcomes was also noted. The most important finding of this study is that applying kinematic alignment in TKA achieves comparable results to mechanical alignment in TKA. This study also shows that restoring the premorbid flexion-extension axis of the knee joint leads to better overall functional results.

conclusionKinematic alignment is a favourable technique for TKA. CLINICAL RELEVANCE: The kinematic alignment idea might be a considerable alternative to mechanical alignment in the future. LEVEL OF EVIDENCE: II.

Indexed as

AgedArthroplasty, Replacement, KneeBiomechanical PhenomenaFemaleHumansKnee JointMaleOsteoarthritis, KneeProspective StudiesRadiographyKinematic alignmentPSIShape matchTKATKRTotal knee arthroplastyTotal knee replacement

Identifiers

PMID27120192

What OpenQuestion holds

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Read underepoch 390

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.