Evidence map›Paper›PMID 38289379›Full record

Trial reportInternational orthopaedics2024

Restoration of constitutional alignment optimizes outcomes of computer navigated total knee arthroplasty: a prospective randomized controlled trial.

Kai Zheng, Yijun Wang, Tianhao Wang, Feng Zhu, Lianfang Zhang, Rongqun Li, Jun Zhou, Dechun Geng, Yaozeng Xu

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in International orthopaedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. [Impact of coronal plane alignment of knee phenotype alteration on short-term effectiveness in robot-assisted total knee arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026
    Article
  2. Is technological-assisted leg axis alignment reliable in total knee arthroplasty with varus-valgus deformities?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Article
  3. Review
  4. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kai Zheng *Department of Orthopaedics, The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou, China.
Yijun Wang *Department of Orthopaedics, The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou, China.
Tianhao Wang *Department of Orthopedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi, China.
Feng ZhuDepartment of Orthopaedics, The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou, China.
Lianfang ZhangDepartment of Orthopaedics, The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou, China.
Rongqun LiDepartment of Orthopaedics, The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou, China.
Jun ZhouDepartment of Orthopaedics, The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou, China.
Dechun GengDepartment of Orthopaedics, The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou, China.
Yaozeng XuDepartment of Orthopaedics, The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou, China. xuyaozeng@163.com.ORCID 0000-0002-0424-4884

Funding

National Natural Science Foundation of China 82072498
6 · The paper itself

Abstract

purposeThe value of computer navigation in total knee arthroplasty (TKA) for arthritic knees continues to be debated. The purpose of this study was to evaluate the value of navigated TKA associated with updated alignment philosophy.

methodsThis prospective randomized controlled trial enrolled 38 consecutive patients (76 knees) and were randomly assigned to both groups. The demographic data and perioperative data were recorded. The coronal plane alignment of the knee (CPAK) classification was used to classify knee alignment phenotypes. Radiographic outcomes were measured and subgroup analysis was further performed. Clinical outcomes were evaluated using patient-reported outcome measures (PROMs). Surgery-related complications were recorded.

resultsThe distribution of CPAK phenotypes following constitutional aligned TKA was equivalent to the native cohort, whereas the mechanical aligned TKA dramatically altered the phenotype distribution from type I and type II to type V and type IV. Final implant positioning was different between groups, with constitutional aligned TKA having larger cTCA (P = .004), joint line obliquity (P = .006), joint line distance (P = .033) and smaller sFCA (P = .013). Subgroup analysis showed higher actual accuracy of component positioning was achieved in navigated TKA, especially in knees with deformity of > 10° (P < .05). Patients reported higher HSS score at three months postoperatively in constitutional aligned group (P = .002). One patient in navigated group suffered femoral pin site fracture caused by a minor trauma.

conclusionComputer navigated TKA allows for restoration of constitutional alignment and minimizes soft tissue release, which when compared to mechanical alignment may be associated with superior early outcomes.

Indexed as

Arthroplasty, Replacement, KneeFemoral FracturesOsteoarthritis, KneeSurgery, Computer-AssistedHumansKnee JointProspective StudiesRetrospective StudiesConstitutional alignmentMechanical alignmentNavigationRandomized controlled trialTotal knee arthroplasty

Identifiers

PMID38289379

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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.