ArticleJournal of experimental orthopaedics2026
3D geometric modelling and clinical validation of lower limb and preliminary 2-year post-operative clinical outcomes of neutral boundary alignment in total knee arthroplasty.
Article in Journal of experimental orthopaedics, 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
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: To introduce a novel three-dimensional (3D) modelling concept for lower limb alignment in total knee arthroplasty (TKA), termed neutral boundary alignment (NBA) and to present preliminary clinical data supporting this physics-based custom alignment strategy. Methods: NBA is defined as the alignment at which the knee joint line is parallel to the ground during the mid-stance phase of gait, achieving static equilibrium with the NBA axis aligned to gravity. A theoretical geometric model of the lower limb was developed, integrating principles of physics to describe this condition. Preliminary clinical validation was performed using radiographic data from an initial cohort of 12 patients, followed by an additional 45 patients who underwent TKA planned and executed using the NBA concept. Postoperative alignment relative to the ideal parallel joint line, intraoperative need for ligament balancing and clinical outcomes were evaluated. Clinical function was assessed using the forgotten joint score (FJS-12) at 2 years postoperatively. Results: Across the combined cohort, postoperative joint line alignment demonstrated an average deviation of 0.1° from the ideal parallel orientation, with a standard deviation of 0.9°. Surgeries performed using NBA consistently achieved stable knees without the need for formal ligament balancing. The mean 2-year postoperative FJS-12 was 86 ± 11, indicating a high level of joint 'forgettability' in daily activities. Conclusions: Despite the relatively small sample size, this study supports NBA as a physics-based, custom alignment method in TKA that closely reproduces a joint line parallel to the ground in mid-stance, optimises knee stability and preserves soft tissue integrity. These preliminary findings justify further investigation of NBA in larger, prospective cohorts. 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.