ReviewJournal of experimental orthopaedics2026
Effect of sagittal alignment on patient outcomes following total knee replacement: A systematic review and correlation analysis.
Review in Journal of experimental orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Effect of sagittal alignment on patient outcomes following total knee replacement: A systematic review and correlation analysis.Journal of experimental orthopaedics · 2026Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: With enhanced implant precision facilitated by robotic technologies, there is renewed attention on the contribution of total knee replacement (TKR) alignment to the 20% post-operative dissatisfaction rate. Although coronal alignment has been extensively studied, the impact of post-operative sagittal alignment on patient-reported outcome measures (PROMs) remains unclear. This review addresses this gap. Methods: We searched five electronic databases (inception-15 February 2025) for studies reporting post-TKR sagittal alignment and PROMs. Case-weighted regression models examined sagittal alignment-PROM relationships at individual post-operative timepoints, across pooled timepoints and using time-adjusted aggregated analyses. Risk of Bias was assessed using ROB2 and ROBINS-I V2 tools. Results: Of 622 studies, 52 were included ( Conclusion: This review provides the first quantitative synthesis linking post-operative sagittal alignment parameters with PROMs. Higher posterior-tibial-slope, femoral flexion, and posterior-condylar offset, and lower femoral-sagittal angle were each significantly associated with improved PROMs, underscoring the importance of sagittal alignment beyond the coronal plane. However, heterogeneity in measurement protocols, underreporting of parameters limit comparability and generalisability. Standardised, multiplanar reporting is essential to help define evidence-based alignment associations and inform surgeons about how best to improve patient outcomes. Level of Evidence: Level I.
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