ReviewEFORT open reviews2020
Clinical outcomes of kinematic alignment versus mechanical alignment in total knee arthroplasty: a systematic review.
Review in EFORT open reviews, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis 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
43 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mechanical versus kinematic alignment for total knee arthroplasty: a meta-analysis.Archives of orthopaedic and trauma surgery · 2025Pooled it
- No differences in functional and clinical outcomes after rehabilitation between modified kinematic and mechanical alignment in total knee arthroplasty: A randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Trial
- Unrestricted kinematic alignment offers limited functional benefit over mechanical alignment in medial pivot total knee arthroplasty: A randomized controlled trial using conventional instrumentation.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Trial
- 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
- Patellofemoral outcomes after kinematic versus mechanical alignment in primary total knee arthroplasty : a focused scoping review of head-to-head comparative studies.Bone & joint open · 2026Article
- Robotic-Assisted Kinematically Aligned Total Knee Arthroplasty Demonstrated Early Rehabilitation and Select Mental Health-Related Quality of Life Improvements Compared to Conventional MA-TKA.Journal of clinical medicine · 2026Article
- Robot-Assisted TKA for Varus Knees: Post Hoc Exploratory Analysis of Alignment Strategy and Deformity Severity.Journal of clinical medicine · 2026Article
- Deep Learning-Based Full-Process Automatic CPAK Classification System and Its Application in the Analysis of Alignment Outcomes Before and After Knee Arthroplasty.Diagnostics (Basel, Switzerland) · 2026Article
- Medial-pivot total knee arthroplasty demonstrates more constrained mid-flexion gait kinematics than posterior-stabilised total knee arthroplasty under standardised soft-tissue balancing: A randomised controlled trial with a healthy reference cohort.Journal of experimental orthopaedics · 2026Article
- A comparative study between two commonly used robotic systems on the accuracy of the intraoperative cuts in total knee arthroplasty.Musculoskeletal surgery · 2026Article
- Lateral deviation of the prosthetic trochlear angle relative to the quadriceps vector in mechanically aligned total knee arthroplasty: a radiological and clinical analysis.BMC musculoskeletal disorders · 2026Article
- Kinematic alignment yields a reduced knee adduction moment and better range of motion compared to mechanical alignment: biomechanical considerations of a staged, bilateral total knee arthroplasty case.BMC musculoskeletal disorders · 2026Article
- Functional versus mechanical alignment in robotic primary total knee arthroplasty: A meta-analysis.SICOT-J · 2026Article
- Mechanical Versus Restrictive Kinematic Alignment in Robotic-Assisted Total Knee Arthroplasty: A Randomized Controlled Trial.Diagnostics (Basel, Switzerland) · 2025Article
- Kinematic alignment in total knee replacement successfully restores the native knee phenotype in the short term.Journal of experimental orthopaedics · 2025Article
- Coronal Alignment in Revision Total Knee Arthroplasty: A Comparison of Cemented Vs Press-Fit Stems for Restoring Mechanical Axis.Arthroplasty today · 2025Article
- Effects of a novel externally rotated trochlear design on patellofemoral kinematics in total knee arthroplasty: A cadaveric study.Journal of experimental orthopaedics · 2025Article
- Standardizing definitions of the total knee alignment techniques: recommendations by the Personalized Arthroplasty Society.EFORT open reviews · 2025Review
- The combination of a medial pivot design with kinematic alignment principles in total knee arthroplasty can ensure a closer to normal knee kinematics than combining mechanical alignment and more traditional implant designs: An umbrella review.Journal of experimental orthopaedics · 2025Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although mechanical alignment (MA) has traditionally been considered the gold standard, the optimal alignment strategy for total knee arthroplasty (TKA) is still debated.Kinematic alignment (KA) aims to restore native alignment by respecting the three axes of rotation of the knee and thereby producing knee motion more akin to the native knee.Designer surgeon case series and case control studies have demonstrated excellent subjective and objective clinical outcomes as well as survivorship for KA TKA with up to 10 years follow up, but these results have not been reproduced in high-quality randomized clinical trials.Gait analyses have demonstrated differences in parameters such as knee adduction, extension and external rotation moments, the relevance of which needs further evaluation.Objective improvements in soft tissue balance using KA have not been shown to result in improvements in patient-reported outcomes measures.Technologies that permit accurate reproduction of implant positioning and objective measurement of soft tissue balance, such as robotic-assisted TKA and compartmental pressure sensors, may play an important role in improving our understanding of the optimum alignment strategy and implant position. Cite this article:
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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.