ArticleBone & joint open2021
Current concepts in total knee arthroplasty : mechanical, kinematic, anatomical, and functional alignment.
Article in Bone & joint open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06507046 (Robotic Assisted Surgery Comparing Personalized Alignment Versus Mechanical Alignment of Total Knee Arthroplasty - A Randomized Controlled Trial), which is not on this map. Cited by 53 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.
Robotic Assisted Surgery Comparing Personalized Alignment Versus Mechanical Alignment of Total Knee Arthroplasty - A Randomized Controlled Trial
Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it, 88 citations in OpenAlex.
- Functional alignment in robotic total knee arthroplasty provides favourable outcomes and minimal early revisions: A systematic review and meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Pooled it
- EPMEDBOT robotic-assisted total knee arthroplasty amplifies the advantage of intraoperative dynamic gap balance and alignment monitoring - a prospective randomized controlled and single center study.Journal of orthopaedic surgery and research · 2025Trial
- Functional alignment is associated with increased incidence of pre-balance, reduced soft-tissue release, and post-operative pain compared to mechanical alignment in patients undergoing simultaneous bilateral robotic-assisted TKA.Journal of robotic surgery · 2023Trial
- [A multicenter randomized controlled trial of domestic robot-assisted and conventional total knee arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2023Trial
- Gap balanced adjusted mechanical alignment versus measured resection mechanical alignment: a randomised controlled trial.Archives of orthopaedic and trauma surgery · 2023Trial
- Femoral rotation and medial flexion gap tightness in functional alignment robotic total knee arthroplasty for varus knees.Journal of robotic surgery · 2026Observational
- Influence of total knee arthroplasty on coronal plane phenotypes and associated clinical outcomes: a CPAK-based comparison between mechanical and functional alignment.Journal of robotic surgery · 2026Article
- Quantifying potential leg axis alteration from extramedullary tibial guide malalignment in total knee arthroplasty: a computer simulation.BMC musculoskeletal disorders · 2026Article
- Sagittal femoral morphology is not associated with coronal alignment phenotypes: A radiographic analysis from the Brescia Knee Research Group.Journal of experimental orthopaedics · 2026Article
- Restricted kinematic alignment in total knee arthroplasty achieves equivalent or superior functional outcomes to mechanical alignment without compromising implant survivorship: A systematic review.Journal of orthopaedics · 2026Review
- Comparable outcomes and early revision rates between restricted and unrestricted functional knee positioning in robotic-assisted total knee arthroplasty for varus deformities ≥10°.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Effect of sagittal alignment on patient outcomes following total knee replacement: A systematic review and correlation analysis.Journal of experimental orthopaedics · 2026Review
- Biomechanical analysis of surgical alignment and design in total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2026Article
- Short-term Outcomes of Unrestricted Kinematic Alignment: Total Knee Arthroplasty With a Medial Pivot Implant: A Japanese Multicenter Study.Arthroplasty today · 2026Article
- Coronal plane alignment of the knee phenotypes and ankle joint coronal plane alignment patterns in Egyptian population.World journal of orthopedics · 2026Article
- A Novel Surgical Technique for Total Knee Arthroplasty Using the Femoral Trochlear Bisector as a New Landmark: Technical Description and Early Clinical Results.Journal of clinical medicine · 2026Article
- Functional alignment preserves the native Coronal Plane Alignment of the Knee phenotype while improving early clinical outcomes after robotic-assisted total knee arthroplasty.Orthopedic reviews · 2026Article
- Article
- Kinematic alignment doesn't tell the whole story: It's time for kinetic alignment.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Functional alignment in robotic total knee arthroplasty achieves comparable outcomes in varus and valgus knees despite distinct intraoperative strategies: Analysis of 355 consecutive cases.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Limb alignment in total knee arthroplasty (TKA) influences periarticular soft-tissue tension, biomechanics through knee flexion, and implant survival. Despite this, there is no uniform consensus on the optimal alignment technique for TKA. Neutral mechanical alignment facilitates knee flexion and symmetrical component wear but forces the limb into an unnatural position that alters native knee kinematics through the arc of knee flexion. Kinematic alignment aims to restore native limb alignment, but the safe ranges with this technique remain uncertain and the effects of this alignment technique on component survivorship remain unknown. Anatomical alignment aims to restore predisease limb alignment and knee geometry, but existing studies using this technique are based on cadaveric specimens or clinical trials with limited follow-up times. Functional alignment aims to restore the native plane and obliquity of the joint by manipulating implant positioning while limiting soft tissue releases, but the results of high-quality studies with long-term outcomes are still awaited. The drawbacks of existing studies on alignment include the use of surgical techniques with limited accuracy and reproducibility of achieving the planned alignment, poor correlation of intraoperative data to long-term functional outcomes and implant survivorship, and a paucity of studies on the safe ranges of limb alignment. Further studies on alignment in TKA should use surgical adjuncts (e.g. robotic technology) to help execute the planned alignment with improved accuracy, include intraoperative assessments of knee biomechanics and periarticular soft-tissue tension, and correlate alignment to long-term functional outcomes and survivorship.
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.