ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Better forgotten joint scores when the angle of the prosthetic trochlea is lateral to the quadriceps vector in kinematically aligned total knee arthroplasty.
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 16 papers.
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Who cites it
16 citing papers in PubMed, 36 citations in OpenAlex.
- Superior Sensitivity of the Forgotten Joint Score in Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials.Arthroplasty today · 2026Article
- Unrestricted kinematic alignment on the sagittal plane: Posterior tibial slope and combined flexion do not have boundaries to respect in terms of short-term clinical outcomes and safety.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Rotational Variability in Arthritic Knee Morphometry Predominantly Arises From the Hip and May Warrant Preoperative Consideration Prior to Total Knee Arthroplasty.Arthroplasty today · 2026Article
- Posterior femoral condylar morphology following mechanical vs. kinematic alignment using a medial-pivot implant designed for mechanical alignment: A CT-based comparative study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 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
- The Forgotten Joint Score after total knee arthroplasty with a kinematic alignment-optimized femoral component matches total hip arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Standardizing definitions of the total knee alignment techniques: recommendations by the Personalized Arthroplasty Society.EFORT open reviews · 2025Review
- 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
- Does Alignment Technique in Medially Stabilized Total Knee Arthroplasty Affect the Patellofemoral Joint Biomechanics and Patient-reported Outcomes at 1 Year? A Prospective Registry-based Cohort Study.Arthroplasty today · 2025Article
- Clinical outcomes of kinematically aligned medial pivot total knee arthroplasty: A systematic review and meta-analysis of current evidence.Journal of experimental orthopaedics · 2025Review
- 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
- Cartilage thickness can be accurately measured intraoperatively in total knee arthroplasty: A step further in calipered kinematic alignment.Journal of experimental orthopaedics · 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
- An Insert Goniometer Can Help Select the Optimal Insert Thickness When Performing Kinematically Aligned Total Knee Arthroplasty with a Medial 1:1 Ball-in-Socket and Lateral Flat Surface Insert and Posterior Cruciate Ligament Retention.Bioengineering (Basel, Switzerland) · 2024Review
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe primary aim was to analyze unrestricted kinematic alignment (unKA) total knee arthroplasty (TKA) and determine the frequency of medial deviation of the prosthetic trochlear angle (PTA) of the femoral component relative to the quadriceps vector (QV) that terminates at the anterior inferior iliac spine (AIIS), and whether patients with medial deviation had a worse Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) relative to those with lateral deviation. The secondary aim was to determine the frequency of medial deviation for mechanical alignment (MA) TKA simulations.
methodsFrom a database of a single surgeon, the study extracted de-identified data on 147 patients with a CT scanogram showing the pelvis and AIIS, a limb with an unKA TKA, and a native (i.e., healthy) opposite limb. On the scanogram, an examiner, blinded to the PROMs, measured the PTA-QV angle on the unKA TKA and on the opposite limb simulated MA TKA by drawing the PTA at 6° valgus relative to the femoral mechanical axis and measuring the PTA-QV angle.
resultsMedial deviation of the PTA occurred in 86% of patients with unKA TKA, and the 126 with medial deviation had a 17/1 point worse median FJS/OKS than the 21 with lateral deviation at a mean follow-up of 47 ± 8 months, respectively (p < 0.0001, p = 0.0053). In addition, 21%, 17%, and 8% of MA TKA had medial deviation after radiographic simulation using reported surgical errors for manual, patient-specific, and robotic instrumentation, respectively.
conclusionIn most patients with unKA TKA and a smaller proportion with MA TKA, a PTA of 6° valgus was medial to the QV, which, by excluding the patient's Q-angle, might alter patellofemoral kinematics like an incorrectly oriented trochleoplasty. The 17-point worse FJS in the patients with an unKA TKA and medial deviation of the PTA suggests the surgical target should be to orient the PTA lateral to the QV. LEVEL OF EVIDENCE: IV.
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