ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
A robotic-assisted simulation of kinematic alignment in TKA leads to excessive valgus and internal rotation in valgus knees.
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 2 papers.
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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.
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Who cites it
2 citing papers in PubMed, 14 citations in OpenAlex.
- Flexion gap discrepancy drives femoral rotational adjustment in robot-assisted TKA: a CPAK-Based phenotypic analysis.BMC musculoskeletal disorders · 2025Article
- Why Kinematic Alignment Makes Little Sense in Valgus Osteoarthritis of the Knee: A Narrative Review.Journal of clinical medicine · 2024Review
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeStrategies to further improve patient satisfaction after total knee arthroplasty include the introduction of new alignment philosophies and more precise instruments such as navigation and robotics. The aim of this study was to investigate the effect of a combination of image-based robotic assistance and the use of modern alignment strategies on the resulting joint line obliquity as well as femoral component rotation and to compare this between varus, neutral and valgus knees.
methodsThis retrospective study included 200 patients who received a robotic-assisted total knee arthroplasty (MAKO
resultsThe mean femoral coronal alignment of the varus, neutral and valgus group, respectively, equalled 0.5° (± 1.1°), 1.1° (± 0.8°) and 1.6° (± 0.7°) of valgus with functional alignment and 2.1° (± 2.1°), 4.1° (± 1.7°) and 6.2° (± 1.7°) of valgus with kinematic alignment. The mean femoral axial alignment of the valgus group resulted in 0.8° (± 2.0°) of internal rotation with functional alignment and 3.9° (± 2.8°) of internal rotation with kinematic alignment. Overall, 186 knees (93%) could be balanced while respecting certain safe zones by using functional alignment as opposed to 54 knees (27% and none in the valgus group) when applying kinematic alignment. Kinematic alignment led to a combination of femoral component valgus and internal rotation of more than 3° in 22 valgus knees (55%), 10 neutral knees (18%) and 3 varus knees (3%) compared to none in each group when applying functional alignment with safe zones.
conclusionsRobotic-assisted kinematic alignment leads to a combination of excessive valgus and internal rotation of the femoral component in valgus and to a lesser extent also in neutral knees when compared with functional alignment. LEVEL OF EVIDENCE: IV.
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