ArticleArthroplasty today2024
The Restoration of the Prearthritic Joint Line Does Not Guarantee the Natural Knee Kinematics: A Gait Analysis Evaluation Following Primary Total Knee Arthroplasty.
Article in Arthroplasty today, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- The Degree of Joint Line Obliquity Change Is Not Associated with Patient Preference in Bilateral Posterior-Stabilized Total Knee Arthroplasties.Journal of clinical medicine · 2026Article
- Comparative efficacy of total knee arthroplasty versus unicompartmental knee arthroplasty in obese patients with medial knee osteoarthritis.Frontiers in medicine · 2026Article
- Beyond the CPAK dogma: robotic FA preserves CPAK better than MA but with equivalent proms at 5-year follow-up.Archives of orthopaedic and trauma surgery · 2025Article
- The combination of a medial pivot design with kinematic alignment principles in total knee arthroplasty can ensure a closer to normal knee kinematics than combining mechanical alignment and more traditional implant designs: An umbrella review.Journal of experimental orthopaedics · 2025Review
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Unrestricted kinematic alignment (uKA) in total knee arthroplasty (TKA) has the theoretical advantage of reproducing patients' constitutional alignment and restoring the pre-arthritic joint line position and obliquity. However, modifications of the original uKA technique have been proposed due to the potential risk of mechanical failure and instability. Given the significant variability in soft tissue behavior within the same bony morphology group, uKA pure knee resurfacing could be occasionally detrimental. This study aimed to kinematically compare the outcomes of uKA TKA with those of a robotic-assisted KA TKA technique based on specific soft-tissue boundaries. Methods: In this retrospective gait analysis study, 24 TKA patients and 12 healthy controls were recruited. Inclusion criteria were a 9-month minimum follow-up from successfully, primary medial-pivot or medially-congruent TKA performed for isolated degenerative joint disease. Preoperatively, patients were randomly assigned to two surgical groups: A) uKA (#12) and B) robot-assisted (#12), KA (hybrid-kinematic) with boundaries (±3° from hip-knee-ankle neutral axis) and a slight intercompartmental gap asymmetry (max 2 mm lateral-opening). The gait analysis was performed using instrumented treadmills equipped with 3D cameras. Results: Sagittal knee kinematic data: during the early-stance phase of gait, the uKA group showed a less consistent weight-acceptance phase and a less efficient transition between the first knee-flexion peak and mid-stance-extension plateau with respect to the hybrid-kinematic alignment group. Spatiotemporal and overall gait quality data: no significant differences were found between the two TKA groups regarding walking speed ( Conclusions: This study showed that restoring the pre-arthritic joint line, as advocated by surgeons following the uKA philosophy, does not guarantee a closer-to-normal knee kinematics.
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