ArticleSICOT-J2022
Functional Alignment Philosophy in Total Knee Arthroplasty - Rationale and technique for the varus morphotype using a CT based robotic platform and individualized planning.
Article in SICOT-J, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 98 papers, 3 of them syntheses that pooled it.
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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
98 citing papers in PubMed, 3 syntheses or guidelines pooled it, 134 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
- Learning curve of robotic-assisted total knee arthroplasty: a literature review.Journal of robotic surgery · 2025Pooled it
- Modern implants in total knee arthroplasty are more patellofemoral joint friendly compared to their traditional design: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2023Pooled it
- Improved accuracy of functional alignment restoration with robotic-assisted total knee arthroplasty : A quasi-randomized controlled trial.Orthopadie (Heidelberg, Germany) · 2026Trial
- Enhancing total knee arthroplasty outcomes: the role of individualized femoral sagittal alignment in robotic-assisted surgery - A randomized controlled trial.Journal of orthopaedic surgery and research · 2024Trial
- Association between abnormal native tibial torsion and poorer clinical outcomes following robotic-assisted total knee arthroplasty: follow-up of at least two years.Journal of robotic surgery · 2026Article
- Long-term outcomes of single-radius total knee arthroplasty in an Asian population: a comparison of cruciate-retaining and posterior-stabilized designs.Knee surgery & related research · 2026Article
- A Comparison of Medial and Lateral Ligament Balance in Functional Versus Simulated Mechanical Alignment in Total Knee Arthroplasty Across CPAK Phenotypes: A Single-Center Study.Journal of clinical medicine · 2026Article
- Kinematical-aligning of femoral component decreases overstuffing of lateral distal condyle and provides better patellar tracking and postoperative outcomes in robotic-assisted total knee arthroplasty.Journal of robotic surgery · 2026Article
- Functional alignment: Defined personalized alignment strategy with promising outcomes and room for improvement.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Preoperative gap phenotypes in functionally aligned robotic total knee arthroplasty: derivation and internal coherence of a driver-based classification.Journal of robotic surgery · 2026Article
- Unicompartmental knee arthroplasty and total knee arthroplasty in patients with 15 or more degrees of varus deformity: age- and gender-matched comparative study of radiographic and clinical outcomes.Archives of orthopaedic and trauma surgery · 2026Article
- Predicting patellar kinematics and contact forces after TKA: a simulation study on quadriceps malalignment.Arthroplasty (London, England) · 2026Article
- Integrating preoperative gait kinematics into total knee arthroplasty planning: Associations with intraoperative robotic laxities and prediction of postoperative function.Journal of experimental orthopaedics · 2026Article
- The three-pillar concept for functional knee positioning in robotic total knee arthroplasty.Journal of experimental orthopaedics · 2026Review
- Final intraoperative gaps commonly exceed resection-based reference gaps during sequential balancing in imageless robot-assisted total knee arthroplasty.Journal of experimental orthopaedics · 2026Article
- Unrestricted kinematic alignment on the sagittal plane: Posterior tibial slope and combined flexion do not have boundaries to respect in terms of short-term clinical outcomes and safety.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Learning curve in image-based robotic assisted total knee arthroplasty: a MAKO-robot experience.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Observational
- 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
- Use of the VELYS Robotic-Assisted Solution in knee arthroplasty: A scoping review.Journal of experimental orthopaedics · 2026Review
38 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 1 institution in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAlignment techniques in total knee arthroplasty (TKA) continue to evolve. Functional alignment (FA) is a novel technique that utilizes robotic tools to deliver TKA with the aim of respecting individual anatomical variations. The purpose of this paper is to describe the rationale and technique of FA in the varus morphotype with the use of a robotic platform. RATIONALE: FA reproduces constitutional knee anatomy within quantifiable target ranges. The principles are founded on a comprehensive assessment and understanding of individual anatomical variations with the aim of delivering personalized TKA. The principles are functional pre-operative planning, reconstitution of native coronal alignment, restoration of dynamic sagittal alignment within 5° of neutral, maintenance of joint-line-obliquity and height, implant sizing to match anatomy and a joint that is balanced in flexion and extension through manipulation of implant positioning rather than soft tissue releases. TECHNIQUE: An individualized plan is created from pre-operative imaging. Next, a reproducible and quantifiable method of soft tissue laxity assessment is performed in extension and flexion that accounts for individual variation in soft tissue laxity. A dynamic virtual 3D model of the joint and implant position that can be manipulated in all three planes is modified to achieve target gap measurements while maintaining the joint line phenotype and a final limb position within a defined coronal and sagittal range.
conclusionFunctional alignment is a novel knee arthroplasty technique that aims to restore constitutional bony alignment and balance the laxity of the soft tissues by placing and sizing implants in a manner that it respects the variations in individual anatomy. This paper presents the approach for the varus morphotype.
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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.