SynthesisJournal of the American Academy of Orthopaedic Surgeons. Global research & reviews2022
Medial Pivot Designs Versus Conventional Bearing Types in Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Synthesis in Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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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
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Alignment strategy does not confer clinically meaningful advantages in medial pivot total knee arthroplasty: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2026Pooled it
- Pooled it
- Early recovery patterns differ between medially congruent and posterior-stabilized total knee arthroplasty, with comparable 2-year outcomes: A triple-blinded randomized clinical trial.Journal of experimental orthopaedics · 2026Article
- Similar secondary patellar resurfacing but higher tibial revision risk with posterior stabilized versus medial pivot total knee arthroplasty: A registry analysis.Journal of experimental orthopaedics · 2026Article
- Excellent Short-Term Outcomes After Kinematic Alignment, Medial-Pivot Total Knee Arthroplasty for Isolated Patellofemoral Osteoarthritis.Arthroplasty today · 2026Article
- Comparison of Radiographic and Patient-Reported Outcomes in Robotic-Assisted Versus Manual Total Knee Arthroplasty Using Medial-Congruent Bearing.Journal of clinical medicine · 2026Article
- Mid-term outcomes of a novel liner design in kinematically-designed cruciate-retaining total knee arthroplasty.World journal of orthopedics · 2026Article
- Comparative Analysis of Medial Knee Pivot vs. Post-stabilized Knee Implants in Patients Undergoing Total Knee Arthroplasty (TKA)-A Systematic Review and Meta-analysis.Indian journal of orthopaedics · 2025Article
- Mobile-bearing versus Medial-pivot Designs in Total Knee Arthroplasty: A Meta-analysis.Knee surgery & related research · 2025Review
- The combination of a medial pivot design with kinematic alignment principles in total knee arthroplasty can ensure a closer to normal knee kinematics than combining mechanical alignment and more traditional implant designs: An umbrella review.Journal of experimental orthopaedics · 2025Review
- A Comparison of Medial-congruent, Ultracongruent, and Cruciate-retaining Bearings Using a Single Cruciate-retaining Total Knee Design.Arthroplasty today · 2025Article
- Medial-Pivot Total Knee Arthroplasty with Kinematic Alignment Produces Similar Clinical Outcomes in Valgus and Varus Deformities.JB & JS open accessArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMedial pivot (MP) designs are growing in popularity. They provide increased sagittal plane stability and theoretically replicate some aspects of native joint kinematics, which may improve total knee arthroplasty outcomes.
methodsA systematic review was performed of randomized controlled trials (RCTs) that compared MP designs with cruciate-retaining, posterior-stabilized (PS), ultracongruent, or mobile-bearings in primary total knee arthroplasty, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcome measures were all clinical function scores, patient-reported outcome measures, and range of motion. The secondary outcome was complications. Two authors independently selected studies, performed data extraction, and risk-of-bias assessment. Studies at high risk of bias were excluded from meta-analysis. Treatment effects were assessed using random-effects meta-analysis and quantified using pooled mean differences or incidence rate differences as appropriate.
resultsEight RCTs met inclusion criteria. Five compared MP with PS, two with ultracongruent, and one with cruciate-retaining and mobile-bearing. In total, 350 knees were randomized to MP and 375 to conventional bearings. One RCT was excluded from meta-analysis because of high risk of bias. Meta-analysis comparing MP with PS only was possible and found no differences at any time points for any outcome measure, including 2-year follow-up for Oxford Knee Score (MD = 0.35 favoring PS; 95% CI -0.49 to 1.20) and range of motion (MD = 1.58 favoring MP; 95% CI -0.76 to 11.92, P = 0.30) and 12 months for Western Ontario Arthritis Index (MD = 4.42 favoring MP; 95% CI -12.04 to 3.20, P = 0.09).
conclusionsThere is no difference in clinical outcomes, with contemporary measurement tools, at any time points, between MP and PS. There are insufficient RCTs comparing MP with other bearings.
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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.