ArticleArthroplasty today2026
Short-term Outcomes of Unrestricted Kinematic Alignment: Total Knee Arthroplasty With a Medial Pivot Implant: A Japanese Multicenter Study.
Article in Arthroplasty today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: This study investigated the short-term postoperative radiological and clinical results of unrestricted kinematic alignment (unKA)-total knee arthroplasty (TKA) using medial pivot (MP) knee prosthesis in a Japanese population. Methods: This multicenter prospective study included 1950 knees (from 384 males and 1566 females; mean age 74.7 years) with complete radiographs, range of motion (ROM) measurements, and minimum 1-year follow-up from a cohort of 2388 knees (462 males and 1926 females; mean age 74.3 years) that underwent unKA-MP-TKA. We classified all patients into the R group (n = 876) within safe ranges (177°≤ hip-knee-ankle angle ≤183°; 85°≤ medial proximal tibial angle ≤95°; 85°≤ lateral distal femoral angle ≤95°) and O group (n = 1074) outside those ranges. Postoperative radiographic and clinical outcomes were compared. Results: The coronal plane alignment of the knee classification changed in 1053 knees (53.1%) preoperatively and postoperatively. Type I to type II was most common (350 knees; 33.8%). ROM significantly improved from -9.2 ± 7.7° and 120.6 ± 16.2° preoperatively to -1.2 ± 3.1° and 122.5 ± 11.8° at the 1-year follow-up. Three knees required reoperation because of patellofemoral joint problems within 1-year postoperatively. ROM outcomes were similar in both groups. Revision surgery owing to tibiofemoral joint complications was not required. Conclusions: UnKA-MP-TKA resulted in the femoral component being placed in valgus, the tibial component in varus, and lower-limb alignment in varus. No revision surgery owing to tibiofemoral joint complications was needed. The short-term postoperative outcomes of unKA-MP-TKA in the Japanese population, who exhibit a high prevalence of varus knee alignment, were favorable whether within or outside the safe ranges. However, the follow-up period was only 1-year, and continued long-term observation is crucial and necessary. Level of Evidence: IV.
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