SynthesisBMC musculoskeletal disorders2023
Postoperative clinical outcomes for kinematically, restricted kinematically, or mechanically aligned total knee arthroplasty: a systematic review and network meta-analysis of randomized controlled trials.
Synthesis in BMC musculoskeletal disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis 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
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Kinematic Alignment Does Not Result in Clinically Important Improvements After TKA Compared With Mechanical Alignment: A Meta-analysis of Randomized Trials.Clinical orthopaedics and related research · 2025Pooled it
- Six-degree-of-freedom knee motion during treadmill walking in mechanically and kinematically aligned TKA.Scientific reports · 2026Trial
- Patellofemoral outcomes after kinematic versus mechanical alignment in primary total knee arthroplasty : a focused scoping review of head-to-head comparative studies.Bone & joint open · 2026Article
- Robot-Assisted TKA for Varus Knees: Post Hoc Exploratory Analysis of Alignment Strategy and Deformity Severity.Journal of clinical medicine · 2026Article
- Restricted kinematic alignment total knee arthroplasty using augmented reality technology to maintain limb alignment within targeted boundaries.Arthroplasty (London, England) · 2026Article
- Alignment Philosophies in Total Knee Arthroplasty: A Comprehensive Narrative Review.Arthroplasty today · 2026Article
- Changes in coronal plane alignment of the knee classification do not significantly influence outcomes after restricted kinematic alignment total knee arthroplasty.Journal of experimental orthopaedics · 2025Article
- [Update 2025: Biomechanics and kinematics after total knee arthroplasty (TKA)].Orthopadie (Heidelberg, Germany) · 2025Article
- Prospective Comparison of Short-Term Outcomes in Kinematic and Mechanical Alignment Total Knee Arthroplasty.Clinics and practice · 2025Article
- Comparison of the accuracy and efficacy of different assistive techniques in primary total knee arthroplasty: A network meta-analysis.Journal of experimental orthopaedics · 2024Article
- Fostering Excellence in Knee Arthroplasty: Developing Optimal Patient Care Pathways and Inspiring Knowledge Transfer of Advanced Surgical Techniques.Journal of healthcare leadership · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMechanically aligned total knee arthroplasty (MATKA) is a well-established procedure. Kinematically aligned TKA (KATKA) has been proposed to restore and preserve pre-arthritic knee anatomy. However, normal knee anatomy varies widely, and there have been concerns regarding restoring unusual anatomy. Accordingly, restricted KATKA (rKATKA) was introduced to reproduce constitutional knee anatomy within a safe range. This network meta-analysis (NMA) aimed to evaluate the clinical and radiological outcomes of the surgeries.
methodsWe performed a database search on August 20, 2022, which included randomized controlled trials (RCTs) comparing any two of the three surgical TKA techniques for knee osteoarthritis. We conducted a random-effects NMA within the frequentist framework and evaluated confidence in each outcome using the Confidence in Network Meta-Analysis tool.
resultsTen RCTs with 1,008 knees and a median follow-up period of 1.5 years were included. The three methods might result in little to no difference in range of motion (ROM) between methods. In patient-reported outcome measures (PROMs), the KATKA might result in a slight improvement compared with the MATKA (standardized mean difference, 0.47; 95% confidence interval [CI], 0.16-0.78; very low confidence). There was little to no difference in revision risk between MATKA and KATKA. KATKA and rKATKA showed a slight valgus femoral component (mean difference [MD], -1.35; 95% CI, -1.95-[-0.75]; very low confidence; and MD, -1.72; 95% CI, -2.63-[-0.81]; very low confidence, respectively) and a slight varus tibial component (MD, 2.23; 95% CI, 1.22-3.24; very low confidence; and MD, 1.25; 95% CI, 0.01-2.49; very low confidence, respectively) compared with MATKA. Tibial component inclination and hip-knee-ankle angle might result in little to no difference between the three procedures.
conclusionsKATKA and rKATKA showed similar ROM and PROMs and a slight variation in the coronal component alignment compared with MATKA. KATKA and rKATKA are acceptable methods in short- to mid-term follow-up periods. However, long-term clinical results in patients with severe varus deformity are still lacking. Surgeons should choose surgical procedures carefully. Further trials are warranted to evaluate the efficacy, safety, and subsequent revision risk.
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