ArticleJournal of experimental orthopaedics2026
Posterior condylar offset and clinical outcomes in medial pivot total knee arthroplasty: A comparison of mechanical and kinematic alignment.
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.
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6 authors.
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Abstract
Purpose: The purpose of this study was to compare preservation of posterior condylar offset (PCO) and posterior condylar offset ratio (PCOR) after medial pivot (MP) total knee arthroplasty (TKA) performed with kinematic (KA) or mechanical alignment (MA), and to assess whether changes in these parameters associate with 2-year clinical outcomes. Methods: This post hoc radiographic analysis of a prospective randomised trial included 200 patients (100 KA, 100 MA). PCO and PCOR were measured on standardised pre and postoperative lateral radiographs. Postoperative values were compared between groups using analysis of covariance, adjusting for preoperative measurements. Associations between changes in PCO/PCOR and 2-year patient-reported outcome measures (PROMs) and range of motion (ROM) were assessed in a subset of 100 patients using multivariable models. Results: Two hundred patients were included radiographically (MA 100, KA 100; mean age 68.9 ± 9.2 years). Adjusted between-group differences were 1.23 mm for postoperative PCO (90% confidence interval [CI]: -0.10 to 2.56; Conclusion: In MP TKA, KA and MA did not differ significantly in preserving PCO or PCOR; however, statistical equivalence within prespecified margins was not established. Changes in PCO/PCOR were not associated with 2‑year outcomes, suggesting that precise surgical execution, including specific rotational strategies, rather than alignment philosophy alone, is key to maintaining posterior femoral geometry in this implant design. Level of Evidence: Level III, post hoc analysis of data from a randomised controlled trial.
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