Evidence mapPaperPMID 40689102Full record

ReviewJournal of experimental orthopaedics2025

The combination of a medial pivot design with kinematic alignment principles in total knee arthroplasty can ensure a closer to normal knee kinematics than combining mechanical alignment and more traditional implant designs: An umbrella review.

Pier F Indelli, Bruno Violante, Pawel Skowronek, Marko Ostojić, Nicolas Bouguennec, Giuseppe Aloisi, Christian Schaller, Umile Giuseppe Longo

Abstract readReview
In one paragraph

Review in Journal of experimental orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
field-weighted citation impact
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

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
  9. Review
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.

Pier F IndelliEuropean Society of Sports Traumatology, Knee Surgery Arthroscopy (ESSKA)-European Knee Associates (EKA) Board Luxembourg Luxembourg.ORCID https://orcid.org/0000-0002-4752-8027
Bruno ViolanteEuropean Society of Sports Traumatology, Knee Surgery Arthroscopy (ESSKA)-European Knee Associates (EKA) Board Luxembourg Luxembourg.
Pawel SkowronekOrthopaedic and Trauma Department Żeromski Specialist Hospital Krakow Poland.ORCID https://orcid.org/0000-0002-4058-3971
Marko OstojićEuropean Society of Sports Traumatology, Knee Surgery Arthroscopy (ESSKA) Basic Science Committee Luxembourg Luxembourg.ORCID https://orcid.org/0000-0002-0108-5750
Nicolas BouguennecEuropean Society of Sports Traumatology, Knee Surgery Arthroscopy (ESSKA) Basic Science Committee Luxembourg Luxembourg.ORCID https://orcid.org/0000-0002-8300-5653
Giuseppe AloisiDipartimento di Medicina Clinica, Sanita' Pubblica, Scienze della Vita e dell'Ambiente Universita' degli Studi dell'Aquila L'Aquila Italy.ORCID https://orcid.org/0000-0003-1470-7253
Christian SchallerEuropean Society of Sports Traumatology, Knee Surgery Arthroscopy (ESSKA)-European Knee Associates (EKA) Board Luxembourg Luxembourg.
Umile Giuseppe LongoEuropean Society of Sports Traumatology, Knee Surgery Arthroscopy (ESSKA)-European Knee Associates (EKA) Board Luxembourg Luxembourg.ORCID https://orcid.org/0000-0003-4063-9821

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: The recent introduction of personalized alignment strategies in total knee arthroplasty (TKA) has transformed adult reconstruction. Proponents advocate for these techniques due to their kinematic benefits compared to traditional methods. Current literature supports combining medial-pivot designs with kinematic alignment (KA) surgery. This review summarizes the application of gait analysis in KA medial-pivot TKA and recommends gait parameters related to patient satisfaction. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). One hundred twenty-one articles from the three search engines underwent a preliminary title/abstract and full-text screening. The final screening resulted in 23 systematic reviews (SR), meta-analyses (M-A) and narrative reviews (NR) as core articles of the current umbrella review. Results: Out of the original 121 SR/M-A/NR articles, 23 (19%) were ultimately evaluated based on the reported results. Twelve articles fell into the first category (gait analysis following TKA as the main topic), five articles were designated for the second category (knee implant design), only one article was classified in the third category (kinematic alignment) and five articles were assigned to the fourth category (a combination of all main topics). Conclusions: The literature investigating the relationship between kinematic and spatiotemporal data and clinical outcomes following KA medial pivot TKA is limited. Few studies included in the current review showed that remote measurements using wearable sensors are more informative than patients' reported outcome measurements (PROMs) regarding a patient's daily level of activities and, ultimately, gait. The current review demonstrated that combining KA and MP designs can ensure a knee kinematic closer to normal than combining MA and more traditional implant designs. Level of Evidence: Level I.

Indexed as

gait analysiskinematic alignmentkneemedial pivotreviewTKA

Identifiers

PMID40689102
PMCPMC12272499

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.