Evidence mapPaperPMID 42260669Full record

ArticleJournal of orthopaedic surgery and research2026

Knee medial tightness after total knee arthroplasty is associated with superior clinical outcomes in Chinese patients: a retrospective cohort study.

Jiawei Hou, Yanlin Zhong, Yichen Zhang, Dong Jiang, Yu Xie, Shuai Li, Guiwu Huang, Zhiqi Zhang

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Article in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Jiawei HouDepartment of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, 510080, China.
Yanlin ZhongDepartment of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, 510080, China.
Yichen ZhangDepartment of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, 510080, China.
Dong JiangDepartment of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, 510080, China.
Yu XieDepartment of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, 510080, China.
Shuai LiDepartment of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, 510080, China.
Guiwu HuangDepartment of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, 510080, China. huanggw7@mail.sysu.edu.cn.
Zhiqi ZhangDepartment of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, 510080, China. zhzhiqi@mail.sysu.edu.cn.

Funding

First Affiliated Hospital of Sun Yat-sen University Ke Ling Funding program for Novel and Distinguished talents R07005Guangzhou Science Funds 2024A04J6487National Natural Science Foundation of China 82572796
6 · The paper itself

Abstract

objectiveIn total knee arthroplasty (TKA), the relationship between joint gap and postoperative prognosis remains unclear. This study aimed to evaluate the impact of the postoperative medial-lateral joint gap difference on clinical outcomes following TKA in Chinese patients with preoperative varus deformity.

methodsIn this retrospective cohort study of 252 knees, patients undergoing primary posterior-stabilized (PS) TKA were grouped by postoperative medial-lateral gap difference. Clinical scores were assessed using KSS, WOMAC and FJS-12 at 1.70 ± 0.42 years of follow-up. Multiple comparisons among groups were performed using appropriate post hoc tests (Tukey or Dunn). Multivariable linear regression was performed to adjust covariates including age, preoperative hip-knee-ankle (HKA) angle gender and body mass index (BMI). Subgroup analyses were conducted to assess the consistency of the association across age, varus severity and BMI. Finite element analysis (FEA) was performed to compare biomechanical responses among healthy, postoperative balanced and postoperative medially tight model (simplified by reducing the medial insert thickness by 1.25 mm).

resultsBoth the medially tight and balanced groups achieved superior outcomes compared with the laterally tight group. Moreover, patients with a gap difference of 1.0-1.5 mm (medially tight) demonstrated greater improvements in total and functional scores than the balanced group. In subgroup analyses, medial tightness was associated with significantly greater improvements in patients aged > 70 years (p < 0.05) and this association were not altered after adjustment for other covariates. No significant differences were observed between the medially tight group and the balanced group in the other subgroups. The medially tight model exhibits a mechanical response that more closely resembles that of healthy individuals than does the balanced model.

conclusionFor Chinese patients undergoing PS TKA, postoperative medial tightness is associated with better short-term functional recovery. Finite element analysis offers supporting evidence for the clinical findings.

Indexed as

Arthroplasty, Replacement, KneeKnee JointOsteoarthritis, KneeAgedChinaCohort StudiesEast Asian PeopleFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeFinite element analysisJoint gap differenceKnee medial tightnessKnee physiological reconstructionTotal knee arthroplasty

Identifiers

PMID42260669
PMCPMC13471653

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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 Socratic graph.