ArticleBone & joint open2022
Kinematic alignment in total knee arthroplasty: a five-year prospective, multicentre, survivorship study.
Article in Bone & joint open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 25 citations in OpenAlex.
- No Difference in 10-year Clinical or Radiographic Outcomes Between Kinematic and Mechanical Alignment in TKA: A Randomized Trial.Clinical orthopaedics and related research · 2025Trial
- The Effect of the Coronal Alignment of Extension Stem on Component Displacement and Stress During Total Knee Arthroplasty: A Finite Element Study.Orthopaedic surgery · 2026Article
- Short-term Outcomes of Unrestricted Kinematic Alignment: Total Knee Arthroplasty With a Medial Pivot Implant: A Japanese Multicenter Study.Arthroplasty today · 2026Article
- External femoral rotation of 2 degrees is associated with the lowest stuffing rates around the femur in functionally aligned TKA.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Comparative outcomes of kinematically aligned TKA with medial stabilized design vs. mechanically aligned TKA with bi-cruciate stabilized design: A propensity score-matched analysis.Journal of orthopaedics · 2025Article
- Article
- Kinematic Alignment of Failed Mechanically Aligned Total Knee Arthroplasty Restored Constitutional Limb Alignment and Improved Clinical Outcomes: A Case Report of 7 Patients.Journal of personalized medicine · 2022Article
- 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
- Personalized alignment™ for total knee arthroplasty using the ROSAFrontiers in surgery · 2022Article
- The Effect of Tibial and Femoral Component Coronal Alignment on Survivorship After Total Knee Arthroplasty: A Systematic Scoping Review of the Literature.JB & JS open accessReview
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe mid-term results of kinematic alignment (KA) for total knee arthroplasty (TKA) using image derived instrumentation (IDI) have not been reported in detail, and questions remain regarding ligamentous stability and revisions. This paper aims to address the following: 1) what is the distribution of alignment of KA TKAs using IDI; 2) is a TKA alignment category associated with increased risk of failure or poor patient outcomes; 3) does extending limb alignment lead to changes in soft-tissue laxity; and 4) what is the five-year survivorship and outcomes of KA TKA using IDI?
methodsA prospective, multicentre, trial enrolled 100 patients undergoing KA TKA using IDI, with follow-up to five years. Alignment measures were conducted pre- and postoperatively to assess constitutional alignment and final implant position. Patient-reported outcome measures (PROMs) of pain and function were also included. The Australian Orthopaedic Association National Joint Arthroplasty Registry was used to assess survivorship.
resultsThe postoperative HKA distribution varied from 9° varus to 11° valgus. All PROMs showed statistical improvements at one year (p < 0.001), with further improvements at five years for Knee Osteoarthritis Outcome Score symptoms (p = 0.041) and Forgotten Joint Score (p = 0.011). Correlation analysis showed no difference (p = 0.610) between the hip-knee-ankle and joint line congruence angle at one and five years. Sub-group analysis showed no difference in PROMs for patients placed within 3° of neutral compared to those placed > 3°. There were no revisions for tibial loosening; however, there were reports of a higher incidence of poor patella tracking and patellofemoral stiffness.
conclusionPROMs were not impacted by postoperative alignment category. Ligamentous stability was maintained at five years with joint line obliquity. There were no revisions for tibial loosening despite a significant portion of tibiae placed in varus; however, KA executed with IDI resulted in a higher than anticipated rate of patella complications.Cite this article:
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