ArticleArchives of orthopaedic and trauma surgery2024
Better restoration of joint line obliquity in tibia first restricted kinematic alignment versus mechanical alignment TKA.
Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Alignment strategy does not confer clinically meaningful advantages in medial pivot total knee arthroplasty: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2026Pooled it
- No differences in functional and clinical outcomes after rehabilitation between modified kinematic and mechanical alignment in total knee arthroplasty: A randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Trial
- Robot-Assisted TKA for Varus Knees: Post Hoc Exploratory Analysis of Alignment Strategy and Deformity Severity.Journal of clinical medicine · 2026Article
- Restricted kinematic alignment in total knee arthroplasty achieves equivalent or superior functional outcomes to mechanical alignment without compromising implant survivorship: A systematic review.Journal of orthopaedics · 2026Review
- Evolving Philosophies of Alignment in TKA: From Mechanical Uniformity to Personalised Harmony.Medicina (Kaunas, Lithuania) · 2026Review
- Total Knee Arthroplasty and the Evolution of Coronal Alignment: From Mechanical to Personalized Strategies.Journal of personalized medicine · 2025Review
- Increased prevalence of lateral trochlear groove wear among valgus alignment subtypes by coronal knee alignment classification: A retrospective single-center study.Journal of orthopaedics · 2025Article
- Increased implant thickness in mechanically aligned off-the-shelf total knee replacement compared to bone resection.Journal of experimental orthopaedics · 2025Article
- Distribution and gender-specific differences of coronal plane alignment of healthy knee.Journal of orthopaedic surgery and research · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn total knee arthroplasty (TKA), suboptimal restoration of joint line obliquity (JLO) and joint line height (JLH) may lead to diminished implant longevity, increased risk of complications, and reduced patient reported outcomes. The primary objective of this study is to determine whether restricted kinematic alignment (rKA) leads to improved restoration of JLO and JLH compared to mechanical alignment (MA) in TKA. MATERIALS AND
methodsThis retrospective study assessed patients who underwent single implant design TKA for primary osteoarthritis, either MA with manual instrumentation or rKA assisted with imageless navigation robotic arm TKA. Pre- and post-operative long standing AP X-ray imaging were used to measure JLO formed between the proximal tibial joint line and the floor. JLH was measured as the distance from the femoral articular surface to the adductor tubercle.
resultsOverall, 200 patients (100 patients in each group) were included. Demographics between the two groups including age, sex, ASA, laterality, and BMI did not significantly differ. Distribution of KL osteoarthritis classification was similar between the groups. For the MA group, pre- to post-operative JLO significantly changed (2.94° vs. 2.31°, p = 0.004). No significant changes were found between pre- and post-operative JLH (40.6 mm vs. 40.6 mm, p = 0.89). For the rKA group, no significant changes were found between pre- and post-operative JLO (2.43° vs. 2.30°, p = 0.57). Additionally, no significant changes were found between pre- and post-operative JLH (41.2 mm vs. 42.4 mm, p = 0.17). Pre- to post-operative JLO alteration was five times higher in the MA group compared to the rKA group, although this comparison between groups did not reach statistical significance (p = 0.09).
conclusionrKA-TKA results in high restoration accuracy of JLO and JLH, and demonstrates less pre- and post-operative JLO alteration compared to MA-TKA. With risen interest in joint line restoration accuracy with kinematic alignment, these findings suggest potential advantages compared to MA. Future investigation is needed to correlate between joint line restoration accuracy achieved by rKA and enhanced implant longevity, reduced risk of post-operative complications, and heightened patient satisfaction.
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