ArticleSICOT-J2026
Precision in Medial pivot total knee arthroplasty: A retrospective study on mechanical axis alignment and functional outcomes with CT-guided patient-specific instrumentation.
Article in SICOT-J, 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
backgroundTotal Knee Arthroplasty (TKA) is the standard treatment for end-stage osteoarthritis, with optimal outcomes dependent on precise mechanical alignment and accurate implant positioning. Patient-specific instrumentation (PSI), facilitated by preoperative CT imaging, has emerged as a technique to enhance surgical precision; however, the relationship between alignment and functional outcomes remains less clear.
objectiveTo evaluate the effectiveness of medial pivot CT-guided PSI TKA in achieving mechanical axis alignment and its correlation with functional outcomes over a 12-month period.
methodsThis retrospective study analysed 389 primary medial pivot TKA procedures performed by a single surgeon between January 2015 and December 2024 using CT-guided PSI. Functional outcomes were assessed using the Oxford Knee Score (OKS) and Lysholm Knee Score (LKS) preoperatively and at three, six, and twelve months postoperatively. Mechanical alignment was evaluated using the Hip-Knee-Ankle (HKA) angle pre- and postoperatively. Descriptive statistics and paired t-tests were applied, with significance set at p < 0.05.
resultsThe cohort included 389 patients, 62.7% female, with a mean age of 69.6 years and mean BMI of 31.4 kg/m
conclusionCT-guided PSI improves mechanical alignment and functional outcomes in medial pivot TKA, particularly in mild to moderate deformities. The weak correlation between alignment and functional recovery suggests other factors, including soft tissue balance, prosthesis factors and rehabilitation, to be critical in total knee arthroplasty. Further studies with larger cohorts, longer follow-up, and comparative groups are required.
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