ArticleJournal of experimental orthopaedics2025
Functional alignment maintains constant medial stability and a more distinct medial pivot pattern throughout flexion compared to mechanical alignment in medial pivot total knee arthroplasty.
Article 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 2 papers.
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Who cites it
2 citing papers in PubMed.
- Medial-pivot total knee arthroplasty demonstrates more constrained mid-flexion gait kinematics than posterior-stabilised total knee arthroplasty under standardised soft-tissue balancing: A randomised controlled trial with a healthy reference cohort.Journal of experimental orthopaedics · 2026Article
- Functional alignment maintains constant medial stability and a more distinct medial pivot pattern throughout flexion compared to mechanical alignment in medial pivot total knee arthroplasty.Journal of experimental orthopaedics · 2025Article
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Authors and funding
14 authors.
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Abstract
Purpose: To investigate whether functional alignment (FA) leads to differences in in vivo kinematics and early clinical outcomes compared to mechanical alignment (MA) in patients undergoing total knee arthroplasty (TKA) using a medial pivot (MP) prosthesis. Methods: Forty patients (20 MA and 20 FA) who underwent TKA with a MP implant were investigated under fluoroscopy during squatting using a two-to-three-dimensional registration technique 1 year postoperatively. FA started with anatomical implant positioning plan, followed by navigation-guided adjustments of femoral and tibial cutting plan based on intraoperative varus-valgus stress testing for soft tissue balance. In MA, resections are aimed for neutral coronal alignment. External rotation, varus-valgus angle, anteroposterior translation of medial and lateral contact points and kinematic pathways were assessed from 0° to 110° of flexion. Clinical outcomes were evaluated 1 year postoperatively using the Knee injury and Osteoarthritis Outcome Score (KOOS) and 2011 Knee Society Score (KSS). The range of motion and radiographic alignment were also evaluated. Results: A significant group × angle interaction was observed for lateral anteroposterior translation, external rotation and valgus angulation ( Conclusion: FA and MA techniques resulted in distinct in vivo kinematics. The FA approach demonstrated MP knee motion with consistent varus-valgus stability throughout flexion, leading to improved early clinical outcomes compared to MA. These findings support the kinematic benefits of FA in MP TKA. Level of Evidence: Level III.
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