ArticleJournal of experimental orthopaedics2026
Removing cartilage in the "unworn" side increases the accuracy in restoring the distal joint line in kinematic alignment 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.
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6 authors.
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Abstract
Purpose: In kinematically aligned total knee arthroplasty (KA-TKA), the restoration of the native joint line is critical to achieving optimal functional outcomes. The conventional assumption of a uniform 2 mm cartilage thickness may lead to errors in distal femoral resections. This study aimed to evaluate whether systematic cartilage removal from the unworn femoral condyle improves the accuracy and consistency of distal joint-line restoration. Methods: A retrospective analysis was conducted on prospectively collected data from 374 patients who underwent primary KA-TKA between March 2023 and March 2025 at a single institution. Patients were divided into two groups: Group A ( Results: Group B (cartilage removed) showed a significantly lower LDFA restoration error (-0.12° ± 0.94°) compared to Group A (-0.35° ± 1.88°) ( Conclusions: Removing cartilage from the unworn femoral condyle significantly enhances the precision and consistency of distal joint line restoration in KA-TKA. This technical refinement may reduce alignment variability and improve reproducibility by addressing interindividual differences in cartilage thickness, which are often underestimated in standard practice. Level of Evidence: Level III, retrospective comparative study.
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