ArticleJournal of experimental orthopaedics2026
Clinical and radiographic outcomes of revision total knee arthroplasty with a medial pivot design for aseptic failure.
Article in Journal of experimental orthopaedics, 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
Purpose: The use of medial pivot inserts in revision total knee arthroplasty (rTKA) remains limited, with more constrained designs often preferred. This study aimed to evaluate clinical, radiographic and complication outcomes of rTKA performed with a medial pivot insert for aseptic revision indications in selected patients with preserved ligamentous stability. Methods: A retrospective analysis was conducted on a prospectively maintained institutional registry. Sixty-three consecutive patients who underwent first-time rTKA with a medial pivot revision system between 2017 and 2023 were included. Indications for revision included aseptic loosening, instability, polyethylene wear and arthrofibrosis, in the presence of mild-to-moderate bone defects (Anderson Orthopaedic Research Institute [AORI] Type I or IIa) and preserved collateral ligament integrity. Clinical outcomes were assessed using the Knee Society Score (KSS), functional KSS (fKSS) and Western Ontario and McMaster Universities Osteoarthritis Index score. Radiographic evaluation included coronal and sagittal alignment parameters and the presence of radiolucent lines (RLLs). A Results: Significant improvements were observed in all clinical outcome measures and knee range of motion (ROM) from preoperative assessment to final follow-up (all Conclusion: rTKA performed with a medial pivot insert for aseptic failure resulted in favourable clinical and radiographic outcomes with a low complication rate at short- to mid-term follow-up. These findings suggest that medial pivot designs may represent a viable option in carefully selected revision cases with mild-to-moderate bone loss and preserved ligamentous stability. Level of Evidence: Level IV.
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