Evidence map›Paper›PMID 40175566›Full record

SynthesisArchives of orthopaedic and trauma surgery2025

Tibia rotational alignment in total knee arthroplasty: Delphi consensus statements from European Knee Society (EKS).

Siegfried Hofmann, Andrea Tecame, Jan Victor, Gerd Seitlinger, Bernardo Innocenti

Abstract readConsensus StatementSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

5 authors.

Siegfried HofmannOrthopedic Department, LKH Murtal-Stolzalpe, Standort Stolzalpe, 8352, Stolzalpe, Stolzalpe 77, Austria.
Andrea TecameDepartment of Orthopaedic and Trauma Surgery, Città di Parma Clinic, Piazzale Athos Maestri, 5, 43123, Parma, Italy.
Jan VictorDepartment Orthopedic Surgery, University Hospital Ghent, C. Heymanslaan 10, 9000, Ghent, Belgium.
Gerd SeitlingerPrivatklinik Wehrle-Diakonissen, Standort Aigen, Guggenbichlerstrasse 20, 5026, Salzburg, Austria.
Bernardo InnocentiBEAMS Department (Bio Electro and Mechanical Systems), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Av. F. Roosevelt, 50 CP165/56, 1050, Brussels, Belgium. bernardo.innocenti@ulb.be.ORCID http://orcid.org/0000-0001-8992-8865

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rotational alignment of the tibial component during total knee arthroplasty (TKA) is critical for ensuring optimal tibiofemoral and patellofemoral joint function. Proper alignment minimizes the risk of tibiofemoral mismatch and patellofemoral instability, which can lead to increased joint stress and compromised kinematics. Traditionally, the tibial tubercle axis (TTA) has been the primary landmark for alignment. However, recent insights into knee three-dimensional anatomy reveal significant variability in TTA positioning, challenging its reliability. This study employs a Delphi consensus methodology among European Knee Society (EKS) experts to address key questions regarding tibial rotational alignment in TKA. Through a systematic literature review and expert discussions, a strong consensus was achieved on three main points: (1) optimal alignment should target both the perpendicularity of the anteroposterior tibial axis to the femoral flexion/extension axis and the accurate positioning of the tibial tubercle relative to the femoral trochlea; (2) while the TTA is effective in 70% of cases, its variability in 30% of knees necessitates alternative strategies; (3) current computer-assisted and robotic technologies do not significantly enhance alignment outcomes. These findings emphasize the importance of individualized assessment of rotational deformities and highlight the potential of advanced data analytics to improve future alignment strategies. The consensus underscores the complexity of achieving optimal tibial alignment and the need for continued research to refine surgical techniques and technologies.

Indexed as

Arthroplasty, Replacement, KneeKnee JointTibiaConsensusDelphi TechniqueEuropeHumansRotationDelphi consensusEKSOptimal tibial alignmentTibial component rotationTTA

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.