ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Mismatch between trochlear coronal alignment of arthritic knees and currently available prosthesis: a morphological analysis of 4116 knees and 45 implant designs.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 29 citations in OpenAlex.
- Overstuffing of the lateral distal condyle is associated with worse intraoperative patellar tracking and postoperative lateral patellar tilt during robotic-assisted cruciate-retaining total knee arthroplasty.Journal of robotic surgery · 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
- The anterior compartment in modern knee arthroplasty.Bulletin of the Hospital for Joint Disease (2013) · 2026Review
- Differences in characteristic morphological variability among distal femurs based on sex and ethnicity.Bone & joint open · 2026Article
- Lateral deviation of the prosthetic trochlear angle relative to the quadriceps vector in mechanically aligned total knee arthroplasty: a radiological and clinical analysis.BMC musculoskeletal disorders · 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
- Patellofemoral alignment safe zones in robotic-assisted total knee arthroplasty do not affect outcomes but do influence patellar resurfacing rates.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Restoration of the trochlear peaks is unnecessary with a kinematic alignment-optimized femoral component as under-stuffing results in equivalent or better patient-reported outcome scores.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- 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
- Femur rotational alignment in total knee arthroplasty: Delphi consensus statements from European knee society (EKS).Archives of orthopaedic and trauma surgery · 2025Article
- The Orientation of the Prosthetic Trochlear Angle Is Predictable in Kinematically Aligned Total Knee Arthroplasty.Journal of personalized medicine · 2025Article
- Restoration of the anterior compartment after robotic total knee arthroplasty significantly improves functional outcome and range of motion at 1 year.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Medial Deviation of a 6° Prosthetic Trochlear Groove After Kinematically Aligned Total Knee Arthroplasty Occurs in Four Types of Coronal Plane Alignment of the Knee (CPAK) and Decreases the Forgotten Joint Score.Arthroplasty today · 2024Article
- The location of the centre of the proximal quadriceps tendon in kinematically aligned total knee arthroplasty is not associated with poor outcome scores or symptomatic patellar instability.Journal of experimental orthopaedics · 2024Article
- The Trochlear Paradox in Native Knees and Its Potential Impact on Total Knee Arthroplasty: An MRI-Based Correlation Study Investigating the Effect of Varying Posterior Femoral Condyle Angles on the Patellofemoral Joint.Journal of clinical medicine · 2024Article
- 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
- Deep Learning for Automated Measurement of Patellofemoral Anatomic Landmarks.Bioengineering (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn up to a fifth of total knee replacements (TKR), surgeons are not capable of achieving good clinical and functional results. Despite comprehensive diagnostic workup, an underlying cause is not always identified in these patients. The purpose of this study is to compare native and prosthetic trochlear anatomies, to evaluate a potential source of morphologic mismatch and theoretically, of poor clinical outcomes.
methodsNative trochlear angles of 4116 knee CTs from 360 Knee Systems database of arthritic pre-operative TKR patients were evaluated. A semi-automated tridimensional analysis was performed to define the native trochlear angle in the coronal plane (NTA) among other 142 parameters. An active search was conducted to identify currently available TKR models; prosthetic trochlear orientation in the coronal plane (PTA) was extracted from the technical data provided by manufacturers.
resultsThe mean native trochlear angle (NTA) was 1.6° ± 6.6° (valgus) with a range from - 23.8° (varus) to 30.3°(valgus). A valgus NTA was present in 60.6% of the knees and 39.4% of them had a varus NTA. 89 TKR models were identified; trochlear details were available for 45 of them, of which 93% were designed with a valgus orientation of the prosthetic trochlear angle (PTA) and 6.9% showed a neutral (0°) PTA. Varus alignment of PTA was not present in any system. Angular numeric values for PTA were available for 34 models; these ranged from 0° to 15° of valgus, with a median value of 6.18° (SD ± 2.88°).
conclusionThis study shows a significant mismatch between native and prosthetic trochlear angles. A relevant proportion of the studied knees (41.45%) fall out of the trochlear angle range of currently available implants; representing a potential source for biomechanical imbalance. While further research is warranted to fully understand the clinical implications of the present study, manufacturers may need to take these findings into account for future implant designs. LEVEL OF EVIDENCE: Level III, retrospective cohort study.
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