ArticleJournal of experimental orthopaedics2023
A new tibial insert design with ball-in-socket medial conformity and posterior cruciate ligament retention closely restores native knee tibial rotation after unrestricted kinematic alignment.
Article in Journal of experimental orthopaedics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 16 citations in OpenAlex.
- Retention or sacrifice of posterior cruciate ligament has no effect on in vitro kinematics in medial pivot total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 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
- Posterior condylar offset and clinical outcomes in medial pivot total knee arthroplasty: A comparison of mechanical and kinematic alignment.Journal of experimental orthopaedics · 2026Article
- Cartilage thickness at the apex of femoral resections in kinematically aligned total knee arthroplasty is close to 2.5 millimeters.Journal of experimental orthopaedics · 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
- Caliper measurements of femoral resection thickness in kinematic alignment total knee arthroplasty are accurate and reproducible.Journal of experimental orthopaedics · 2025Article
- No Radiographic Evidence of Medial Collateral Ligament Elongation in Valgus Osteoarthritic Knees Enables Treatment with Kinematically Aligned Total Knee Arthroplasty.The journal of knee surgery · 2025Article
- Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping Review.Medicina (Kaunas, Lithuania) · 2025Article
- 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
- Retention of the posterior cruciate ligament stabilizes the medial femoral condyle during kneeling using a tibial insert with ball-in-socket medial conformity.International orthopaedics · 2024Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn total knee arthroplasty (TKA) with posterior cruciate ligament (PCL) retention, the medial and lateral insert conformity that restores in vivo native (i.e., healthy) knee tibial rotation and high function without causing stiffness is unknown. The purpose was to determine whether a ball-in-socket (B-in-S) medially conforming (MC) and flat lateral insert implanted with unrestricted kinematic alignment (KA) TKA and PCL retention restores tibial rotation to native.
methodsOne group of 25 patients underwent unrestricted KA TKA with manual instruments. Another group of 25 patients had native knees. Single-plane fluoroscopy imaged each knee while patients performed step-up and chair rise activities. Following 3D model-to-2D image registration, anterior-posterior (A-P) positions of the femoral condyles were determined. Changes in A-P positions with flexion were used to determine tibial rotation.
resultsAt maximum flexion, mean tibial rotations of KA TKA knees were comparable to native knees (Step up: 12.3° ± 4.4° vs. 13.1° ± 12.0°, p = 0.783; Chair Rise: 12.7° ± 6.2° vs. 12.6° ± 9.5º, p = 0.941). However, paths of rotation differed in that screw home motion was less evident in KA TKA knees. At 8 months follow-up, the median Forgotten Joint Score was 69 points (range 65 to 85), the median Oxford Knee Score was 43 points (range 40 to 46), and mean knee flexion was 127º ± 8°.
conclusionsThe ball-in-socket medial, flat lateral insert and PCL retention implanted with unrestricted KA TKA restored in vivo native knee tibial rotation at maximum flexion for each activity and high function without stiffness. Providing high A-P stability, this implant design might benefit patients desiring to return to demanding work and recreational activities. LEVEL OF EVIDENCE: Therapeutic - Level II.
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