ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026
Unrestricted kinematic alignment on the sagittal plane: Posterior tibial slope and combined flexion do not have boundaries to respect in terms of short-term clinical outcomes and safety.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePersonalized alignment in total knee arthroplasty (TKA) is gaining traction as a surgical philosophy. True personalization, however, must encompass not only the coronal plane but also the sagittal and axial planes. This study evaluates influence of the Tibial Slope (PTS) and combined flexion (CF) on outcomes in TKA performed using unrestricted kinematic alignment (KA). The aim of the study was to examine the relationship between PTS or CF and both functional outcomes and complication rates.
methodsA retrospective review was conducted on 137 patients who underwent primary TKA using KA between November 2022 and June 2023. CF was calculated by combining PTS and DFF values. Patients were categorized into groups based on CF angle (≤7.5° vs. >7.5°) and PTS (<5, between 5 and 10, >10). Clinical outcome measures (KSS, OKS, SF12 and FJS), radiographic alignment parameters and complication rates were analyzed.
resultsThere were no statistically significant differences between groups regarding implant survivorship, revision rates, mechanical failure, or clinical outcome scores. CF or PTS did not correlate with postoperative coronal alignment parameters or with patient-reported outcome measures (PROMs). Additionally, the change in clinical scores from preoperative to postoperative assessments did not differ significantly between groups, indicating comparable clinical improvement regardless of CF or PTS.
conclusionsThe findings suggest that restoration of native femoral and tibial flexion within a kinematic alignment does not adversely affect outcomes or increase complication rates, providing similar clinical benefits regardless the prearthritic CF or tibial slope of the patients, supporting the short-term safety of this "unrestricted" approach in the sagittal plane. LEVEL OF EVIDENCE: Level IV.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.