ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022
Reoperations are few and confined to the most valgus phenotypes 4 years after unrestricted calipered kinematically aligned TKA.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 42 citations in OpenAlex.
- The anterior compartment in modern knee arthroplasty.Bulletin of the Hospital for Joint Disease (2013) · 2026Review
- Unrestricted kinematic alignment for total knee arthroplasty : a mid- to long-term follow-up non-designer single surgeon study with survival analysis.Bone & joint open · 2026Article
- Partial lateral patellar facetectomy in primary total knee arthroplasty: a common addition with limited support.EFORT open reviews · 2026Review
- Restricted kinematic alignment total knee arthroplasty using augmented reality technology to maintain limb alignment within targeted boundaries.Arthroplasty (London, England) · 2026Article
- Unrestricted Kinematic Alignment Is a Feasible Strategy for Lateral Compartment Osteoarthritis: Short-Term Outcomes of a Contralateral Knee-Referenced Approach.Journal of clinical medicine · 2026Article
- Switching From a 6° to a 20° Valgus Prosthetic Trochlear Groove Improved the Forgotten Joint and Oxford Knee Scores After Kinematically Aligned Total Knee Arthroplasty.Arthroplasty today · 2026Article
- Valgus knee deserves personalized total knee arthroplasty.EFORT open reviews · 2026Review
- Femoral component rotational alignment in robotic-assisted total knee arthroplasty with functional knee positioning varies across knee phenotypes without affecting clinical outcomes.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Observational
- Robotic-assisted bi-cruciate stabilized TKA with a 3-degree varus inclination does not affect PROMs, regardless of pre-arthritic CPAK classification matching.Archives of orthopaedic and trauma surgery · 2025Article
- The Forgotten Joint Score after total knee arthroplasty with a kinematic alignment-optimized femoral component matches total hip arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- No Radiographic Evidence of Medial Collateral Ligament Elongation in Valgus Osteoarthritic Knees Enables Treatment with Kinematically Aligned Total Knee Arthroplasty.The journal of knee surgery · 2025Article
- Phenotype-considered kinematically aligned total knee arthroplasty for windswept-deformity-associated osteoarthritis: surgical strategy and clinical outcomes.Knee surgery & related research · 2024Article
- Review
- Better forgotten joint scores when the angle of the prosthetic trochlea is lateral to the quadriceps vector in kinematically aligned total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Influence of Mechanical Alignment on Functional Knee Phenotypes and Clinical Outcomes in Primary TKA: A 1-Year Prospective Analysis.Journal of personalized medicine · 2023Article
- More passive internal tibial rotation with posterior cruciate ligament retention than with excision in a medial pivot TKA implanted with unrestricted caliper verified kinematic alignment.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Functional Alignment Philosophy in Total Knee Arthroplasty-Rationale and Technique for the Valgus Morphotype Using an Image Based Robotic Platform and Individualized Planning.Journal of personalized medicine · 2023Article
- The Trochlear Groove of a Femoral Component Designed for Kinematic Alignment Is Lateral to the Quadriceps Line of Force and Better Laterally Covers the Anterior Femoral Resection Than a Mechanical Alignment Design.Journal of personalized medicine · 2022Article
- Six Commonly Used Postoperative Radiographic Alignment Parameters Do Not Predict Clinical Outcome Scores after Unrestricted Caliper-Verified Kinematically Aligned TKA.Journal of personalized medicine · 2022Article
- A TKA Insert with A Lateral Flat Articular Surface Maximizes External and Internal Tibial Orientations without Anterior Lift-Off Relative to Low- and Ultracongruent Surfaces.Journal of personalized medicine · 2022Article
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Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe present study determined the postoperative phenotypes after unrestricted calipered kinematically aligned (KA) total knee arthroplasty (TKA), whether any phenotypes were associated with reoperation, implant revision, and lower outcome scores at 4 years, and whether the proportion of TKAs within each phenotype was comparable to those of the nonarthritic contralateral limb.
methodsFrom 1117 consecutive primary TKAs treated by one surgeon with unrestricted calipered KA, an observer identified all patients (N = 198) that otherwise had normal paired femora and tibiae on a long-leg CT scanogram. In both legs, the distal femur-mechanical axis angle (FMA), proximal tibia-mechanical axis angle (TMA), and the hip-knee-ankle angle (HKA) were measured. Each alignment angle was assigned to one of Hirschmann's five FMA, five TMA, and seven HKA phenotype categories.
resultsThree TKAs (1.5%) underwent reoperation for anterior knee pain or patellofemoral instability in the subgroup of patients with the more valgus phenotypes. There were no implant revisions for component loosening, wear, or tibiofemoral instability. The median Forgotten Joint Score (FJS) was similar between phenotypes. The median Oxford Knee Score (OKS) was similar between the TMA and HKA phenotypes and greatest in the most varus FMA phenotype. The phenotype proportions after calipered KA TKA were comparable to the contralateral leg.
conclusionUnrestricted calipered KA's restoration of the wide range of phenotypes did not result in implant revision or poor FJS and OKS scores at a mean follow-up of 4 years. The few reoperated patients had a more valgus setting of the prosthetic trochlea than recommended for mechanical alignment. Designing a femoral component specifically for KA that restores patellofemoral kinematics with all phenotypes, especially the more valgus ones, is a strategy for reducing reoperation risk. LEVEL OF EVIDENCE: Therapeutic, Level III.
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