Evidence map›Paper›PMID 42606776›Full record

ReviewMusculoskeletal surgery2026

Kinematic alignment versus mechanical alignment in total knee arthroplasty: a systematic review and meta-analysis of medium to long-term outcomes.

Abdelrahman Abdalla Mohamed, Abdalla Ahmed Mohamed, A F Alkarghali, A Amirat, A H Zein, M E Abdelsattar, M Al-Badaineh, M F Hammad

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Review in Musculoskeletal surgery, 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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0citing papers in PubMed
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1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Abdelrahman Abdalla MohamedFaculty of Medicine, October 6 University, Giza, Egypt.
Abdalla Ahmed MohamedFaculty of Medicine, October 6 University, Giza, Egypt. aahimsh@gmail.com.ORCID https://orcid.org/0009-0009-8338-0531
A F AlkarghaliFaculty of Medicine, University of Tripoli, Tripoli, Libya.
A AmiratFaculty of Medicine, University of Algiers 1, Algiers, Algeria.
A H ZeinFaculty of Medicine, Minia University, Minia, Egypt.
M E AbdelsattarFaculty of Medicine, Alexandria University, Alexandria, Egypt.
M Al-BadainehFaculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
M F HammadThe University of Texas MD Anderson Cancer Center, Houston, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposesTo compare medium- to long-term patient-reported outcomes, objective function, pain, range of motion, and revision/reoperation risk between kinematic (KA) and mechanical alignment (MA) in primary total knee arthroplasty (TKA) using randomized trials.

methodsA systematic review and meta-analysis followed PRISMA and Cochrane guidelines. Randomized controlled trials comparing KA and MA in primary TKA with ≥ 24 months follow-up were identified through PubMed, Scopus, Cochrane, and Web of Science. Pooled mean or standardized mean differences and risk ratios were calculated using random-effects models. Outcomes were stratified into mid-term (24-60 months) and long-term (> 60 months) windows. Certainty of evidence was assessed using GRADE.

resultsTen unique RCTs (13 articles, 934 knees, follow-up 2-13 years) were included. Mid-term analyses favored KA in Forgotten Joint Score (MD 4.06, 95% CI 2.39-5.74), WOMAC (MD -5.51, 95% CI -10.27 to -0.74), and VAS pain (MD -0.39, 95% CI -0.58 to -0.19). Long-term follow-up revealed no significant functional differences. Revision risks were comparable (RR 1.32, 95% CI 0.59-2.93). Certainty of evidence ranged from moderate (OKS, VAS) to very low (FJS, WOMAC, KSS, ROM).

conclusionKA yields modest mid-term improvements in awareness and pain over MA, though differences rarely reached clinical importance thresholds. Long-term outcomes, survivorship, and complications were comparable. KA is a viable personalized TKA strategy, pending confirmation from larger randomized trials.

Indexed as

Kinematic alignmentMechanical alignmentPatient reported outcome measures (PROMs)Randomized controlled trialsTotal knee arthroplasty

Identifiers

PMID42606776

What OpenQuestion holds

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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.