ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
Improved quadriceps efficiency with a medial pivot in comparison to a cruciate-retaining design in total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 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
- 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
- Similar secondary patellar resurfacing but higher tibial revision risk with posterior stabilized versus medial pivot total knee arthroplasty: A registry analysis.Journal of experimental orthopaedics · 2026Article
- Medial femoral condyle restoration technique in total knee arthroplasty.Arthroplasty (London, England) · 2026Article
- Clinical outcomes of kinematically aligned medial pivot total knee arthroplasty: A systematic review and meta-analysis of current evidence.Journal of experimental orthopaedics · 2025Review
- Improved quadriceps efficiency with a medial pivot in comparison to a cruciate-retaining design in total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
purposeThe posterior cruciate-retaining (CR) design offers rotational freedom but risks abnormal kinematics and instability. The medial pivot (MP) design mimics native joint motion with a high-conformity medial and flat lateral interface. Within clinical studies, the MP design outclassed the CR design, but biomechanical studies are lacking. This study investigates the tibiofemoral and patellofemoral kinematics of both implant designs compared to native kinematics.
methodsEight fresh-frozen cadaveric knee specimens underwent total knee arthroplasty using MP and CR designs. Testing was performed in a dynamic knee rig simulating active knee flexion (30-130°) under muscle load. Biomechanical assessments included tibial rotation, tibiofemoral translation, patellar tilt/shift, patellofemoral contact/pressure patterns and quadriceps force. Functional regressions were used to analyse the effects of the component designs on the native situation.
resultsThe MP design exhibited increased tibial rotation (130° flexion: MP 9.4° vs. CR 6.6°) and lateral anterior tibial translation during flexion (130° flexion: MP 25.8 mm vs. CR 22.6 mm). Both designs showed no significant differences in patellar tilt or shift and similar patellofemoral pressure (CR 3.2 MPa, MP 3.4 MPa) and contact patterns (CR 213.8 mm
conclusionThe MP design provides a more native-like knee kinematic profile than the CR design, with a more pronounced MP motion pattern and reduced quadriceps loading. LEVEL OF EVIDENCE: Not applicable.
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