Evidence map›Paper›PMID 34487188›Full record

Observational studyKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022

Wide variation in tibial slopes and trochlear angles in the arthritic knee: a CT evaluation of 4116 pre-operative knees.

Kaushik Hazratwala, William B O'Callaghan, Shilpa Dhariwal, 360 Knee Group, Matthew P R Wilkinson

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study 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 31 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 1 pooled it
6.3field-weighted citation impact, top 3% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.

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  6. Does patellar resurfacing matter in robotic-assisted total knee arthroplasty with functional alignment principles?Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Kaushik HazratwalaThe Orthopaedic Research Institute of Queensland (ORIQL), 7 Turner St, Pimlico, QLD, 4812, Australia. drkosh@qllc.com.au.ORCID http://orcid.org/0000-0002-0649-9231
William B O'CallaghanThe Orthopaedic Research Institute of Queensland (ORIQL), 7 Turner St, Pimlico, QLD, 4812, Australia.
Shilpa Dhariwal360 Knee Systems, Pymble, NSW, Australia.
360 Knee Group
Matthew P R WilkinsonThe Orthopaedic Research Institute of Queensland (ORIQL), 7 Turner St, Pimlico, QLD, 4812, Australia.
Sydney Orthopaedic Research Institute · AUBAE Systems (Sweden) · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAs surgeons continue to grapple with persistent issues of patient dissatisfaction post-TKA, the literature has focused on the coronal plane when considering alignment strategies but has largely ignored the sagittal and axial planes. The purpose of this retrospective observational cohort study is to evaluate variability in knee anatomy and alignment beyond the coronal plane and rationalise how this relates to existing arthroplasty alignment philosophies.

methods4116 knee CTs from 360 Knee Systems© database of arthritic pre-operative TKA patients were evaluated. Standardised bony landmarks were used in each CT to determine the hip-knee angle, medial proximal tibial angle, lateral distal femoral angle, medial plateau posterior tibial slope, lateral plateau posterior tibial slope, trochlea angle (TA) to distal femoral angle (TA-DFA) and TA to posterior condylar angle (TA-PCA). Analysis was performed to determine the distributions of each measure across the cohort population.

resultsBoth the medial and lateral PTS ranged from 5° anterior to 25° posterior. 22.6% of patients had differential PTS greater than 5°. 14.5% have greater lateral PTS (mean difference to medial PTS of 4.8° ± 5.0°), whilst 31.0% have greater medial PTS (mean difference to lateral PTS of 5.7° ± 3.2°). 14% of TA-DFAs and 5.2% of TA-PCAs vary greater than 10°.

conclusionThis study demonstrates a wide variation in tibial slope, differential slope between the medial and lateral tibial plateau as well as variation in the trochlear geometry. There has been an overemphasis in the literature on coronal alignment, ignoring the considerable variability present in tibial and patellofemoral morphology. Existing arthroplasty techniques are based on assumptions that may not adequately address the anatomy of morphologic outliers and could lead to dissatisfaction. LEVEL OF EVIDENCE: III-retrospective cohort study.

Indexed as

Arthroplasty, Replacement, KneeOsteoarthritis, KneeHumansKnee JointRetrospective StudiesTibiaTomography, X-Ray ComputedAlignment strategiesCoronalKinematic alignmentMechanical alignmentPosterior tibial slopeSagittalTotal knee arthroplastyTotal knee replacementTrochlear angles

Identifiers

PMID34487188
OpenAlexW3196697565

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.