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448 references · Organized by clinical topic
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448 of 448 references
Anatomy & joint-line geometry36 references
- A correlative study of the geometry and anatomy of the distal femur.pdf
- Automatic methods for characterization of sexual dimorphism of adult femora-distal femur.pdf
- Bellemans-CORR12-constitutional varus.pdf
- Coronal alignment of the lower limb.pdf
- Coronal and sagittal alignment of the lower limb in Caucasians- Analysis of a 3D CT database.pdf
- Coronal Plane Alignment of the Knee (CPAK) classification- a new system for describing knee phenotypes.pdf
- CPAK.pdf
- Cylindrical Axis, Not Epicondyles, Approximates Perpendicular to Knee Axes.pdf
- Dalury-CORR01-Observations_of_the_Proximal_Tibia_in_Total_Knee.21.pdf
- Differences between X-ray and MRI-determined knee cartilage thickness in weight-bearing and non-weight-bearing conditions.pdf
- Eckhoff-CORR-AN ABJS BEST PAPER_Difference Between the Epicondylar and Cylindrical Axis of the Knee.pdf
- Elias-CORR90-A_Correlative_Study_of_the_Geometry_and_Anatomy_of.18.pdf
- Extreme Variability in Posterior Slope of the Proximal Tibia Measurements on 2,395 CT Scans of Patients Undergoing UKA.pdf
- Femoral bone and cartilage wear is predictable at 0° and 90° in the osteoarthritic knee treated with total knee arthroplasty.pdf
- Femoral Condyle Geometry in the Normal and Varus Knee.pdf
- Functional joint line obliquity after kinematic total knee arthroplasty.pdf
- Hancock-CORR13-CA not epicondyles approximate FE axis.pdf
- Howell, KSSTA Phenotype2021.pdf
- Increased prevalence and severity of femoral bone wear in Japanese patients with varus knee osteoarthritis.pdf
- Is Neutral Mechanical Alignment Normal for All Patients- The Concept of Constitutional Varus.pdf
- Kinematic Alignment TKA Aligns the Ankle Joint Line Closer to Those of the Native Ankle than Mechanically Aligned TKA in Bipedal Stance.pdf
- Kinematically aligned TKA can align knee joint line to horizontal.pdf
- Knee surg sports traumatol arthrosc - 2026 - Nedopil - A fixed 2 mm adjustment for worn distal femoral cartilage when the.pdf
- Mismatch between femur and tibia coronal alignment in the knee joint- classification of five lower limb types according to femoral and tibial mechanical alignment.pdf
- Modern total knee arthroplasty designs do not reliably replicate anterior femoral morphology.pdf
- Morphometric analysis of the distal femur in total knee arthroplasty and native knees.pdf
- Phenotyping the knee in young non-osteoarthritic knees shows a wide distribution of femoral and tibial coronal alignment.pdf
- Posterior Tibial Slope in Computer-Navigated Total Knee Arthroplasty- The Transmalleolar Sagittal Axis Underestimates Slope Compared to Traditional Intramedullary Axis.pdf
- Radiographic analysis of the axial alignment of the lower extremity.pdf
- Surgical implications of varus deformity of the knee with obliquity of joint surfaces.pdf
- The Geometry of the Tibial Plateau and Its Influence on the Biomechanics of the Tibiofemoral Joint.pdf
- The kinematic alignment technique for TKA reliably aligns the femoral component with the cylindrical axis.pdf
- Three-dimensional morphology of the distal part of the femur viewed in virtual reality. Part II.pdf
- Three-dimensional morphology of the distal part of the femur viewed in virtual reality. Part II.pdf
- Unrestricted kinematic alignment corrects fixed flexion contracture in robotically aligned total knees without raising the joint line.pdf
- Validation of cartilage depth in total knee arthroplasty.pdf
Ligaments & soft-tissue balance32 references
- A Total Knee Arthroplasty Is Stiffer When the Intraoperative Tibial Force Is Greater than the Native Knee.pdf
- Analysis of differences in laxities and neutral positions from native after kinematically aligned TKA using cruciate retaining implants.pdf
- Collateral Ligament Laxity in Knees- What Is Normal.pdf
- Contact forces in the tibiofemoral joint from soft tissue tensions- Implications to soft tissue balancing in total knee arthroplasty.pdf
- Do varus or valgus outliers have higher forces in the medial or lateral compartments than those which are in-range after a kinematically aligned total knee arthroplasty.pdf
- Giustra et al 2025 - PCL Retention in KA (Persona MC) - JCM.pdf
- Howell-Soft Tissue Balancing in Total Kne-2017.pdf
- In Vivo Elongation Patterns of the Collateral Ligaments in Healthy Knees During Functional Activities.pdf
- In Vivo Elongation Patterns of the Collateral Ligaments in Healthy Knees During Functional Activities.pdf
- In vivo knee laxity in flexion and extension- A radiographic study in 30 older healthy subjects.pdf
- In vivo Length Change Patterns of the Medial and Lateral Collateral Ligaments along the Flexion Path of the Knee.pdf
- Kinematically aligned total knee arthroplasty reproduces more native rollback and laxity than mechanically aligned total knee arthroplasty- A matched pair cadaveric study.pdf
- Medial and lateral gap laxity differential in computer-assisted kinematic total knee arthroplasty.pdf
- Mid-Flexion Anteroposterior Stability of Total Knee Replacement Implanted with Kinematic Alignment- A Randomized, Quantitative Radiographic Laxity Study with Posterior-Stabilized.pdf
- Mid-flexion laxity in the asymptomatic native knee is predominantly present on the lateral side.pdf
- Nedopil-J knee Surg 2021 copy.pdf
- Posterior cruciate ligament retention with medial ball-in-socket conformity promotes internal tibial rotation and knee flexion while providing high clinical outcome scores.pdf
- Posterior cruciate ligament retention with medial ball-in-socket conformity promotes internal tibial rotation and knee flexion while providing high clinical outcome scores.pdf
- Rajgopal-Knee Surg Sports Traumatol Arthr-2023.pdf
- Restoring the constitutional alignment with a restrictive kinematic protocol improves quantitative soft-tissue balance in total knee arthroplasty- a randomized controlled trial.pdf
- Restoring the constitutional alignment with a restrictive kinematic protocol improves quantitative soft-tissue balance in total knee arthroplasty.pdf
- Roth JOR 2015.pdf
- Roth_JOR_2015_supplement.pdf
- Roth, ISAKOS, 2017.pdf
- Roth, JBJS, 2015.pdf
- Shelton-Clin Orthop Relat Res-2018.pdf
- Shelton-JKS18-TKA with high intraop force.pdf
- Shelton, JKS, 2018.pdf
- te Molder-KSSTA19-mid-flex lax asympt native knee.pdf
- The flexion gap in normal knees-An MRI Study.pdf
- Tokuhara-BJJ04-the flexion gap in normal knees MRI study.pdf
- Tokuhara-BJJ04-the flexion gap in normal knees MRI study.pdf
Kinematics, gait & knee motion34 references
- Delman-Knee Surg Sports Traumato-In Press 2021 copy.pdf
- Does standing limb alignment after total knee arthroplasty predict dynamic alignment and knee loading during gait.pdf
- Does the femur roll-back with flexion.pdf
- Eckhoff-JBJS03-Three-Dimensional Morphology and Kinematics of the Distal Part of the Femur Viewed in Virtual Reality_Part II.pdf
- Freeman-COOR03-The_Movement_of_the_Knee_Studied_by_Magnetic.7.pdf
- Freeman-J Biomech05-movement of a normal tibiofemoral joint.pdf
- Hollister-CORR93-The_Axes_of_Rotation_of_the_Knee.33.pdf
- Howell, KSSTA, Kinematics 2012.pdf
- Howell, Ortho, Kinematics 2009.pdf
- Hull-Knee Surgery, Sports Traumatology, A-2022.pdf
- In vivo fluoroscopic analysis of fixed-bearing total knee replacements.pdf
- Iwaki-BJJ00-tibiofemoral movement unloaded cadaver.pdf
- Journal Orthopaedic Research - 2009 - Victor - The influence of muscle load on tibiofemoral knee kinematics.pdf
- Kinematic Alignment Compared With Mechanical Alignment Techniques Results in Greater Peak Three-Dimensional Knee Joint Moments During Stair Negotiation.pdf
- Kinematic alignment in total knee arthroplasty better reproduces normal gait than mechanical alignment.pdf
- Kinematic Evaluation of the GMK Sphere Implant During Gait Activities- A Dynamic Videofluoroscopy Study.pdf
- Kinematically aligned total knee arthroplasty reduces knee adduction moment more than mechanically aligned total knee arthroplasty.pdf
- Kinematically aligned total knee arthroplasty reduces knee adduction moment more than mechanically aligned total knee arthroplasty.pdf
- Nicolet-Petersen, KSSTA, 2019_Small differences in tibial contact locations.pdf
- Niki-KSSTA18-KA has lower adduction moment than MA.pdf
- No difference in outcomes and gait analysis between mechanical and kinematic knee alignment methods using robotic total knee arthroplasty.pdf
- Pinskerova-BJJ04-Does the femur roll-back.pdf
- Pinskerova-BJJ04-Does the femur roll-back.pdf
- Restoration of Joint Line Obliquity May Not Influence Lower Extremity Peak Frontal Plane Moments During Stair Negotiation.pdf
- Salvi et al 2024 - JLO and Natural Kinematics - Arthro Today.pdf
- The axes of rotation of the knee.pdf
- The knee in full flexion- an anatomical study.pdf
- The Movement of the Knee Studied by Magnetic Resonance Imaging.pdf
- The movement of the normal tibio-femoral joint.pdf
- The transepicondylar axis approximates the optimal flexion axis of the knee.pdf
- Three-dimensional mechanics, kinematics, and morphology of the knee viewed in virtual reality.pdf
- Three-dimensional mechanics, kinematics, and morphology of the knee viewed in virtual reality.pdf
- THREE‐DIMENSIONAL MECHANICS, KINEMATICS, AND MORPHOLOGY OF THE KNEE VIEWED IN VIRTUAL REALITY.pdf
- Tibiofemoral movement 2- the loaded and unloaded living knee studied by MRI.pdf
Patellofemoral joint & trochlear tracking92 references
- 11999_2012_Article_2741.pdf
- 167_2022_Article_7251.pdf
- A laterally positioned concave trochlear groove prevents patellar dislocation.pdf
- A laterally positioned concave trochlear groove prevents patellar dislocation.pdf
- Anatomic rotational relationships of the proximal tibia, distal femur, and patella- implications for rotational alignment in total knee arthroplasty.pdf
- Anglin C et al. (2008) · Determinants of patellar tracking in total knee arthroplasty.PubMed record · Eight cadaveric knees, passive and loaded rigs. Component placement and resection angle influenced tracking in condition-dependent ways. This isolated model does not reproduce those biomechanical experiments.
- Are current total knee arthroplasty implants designed to restore normal trochlear groove anatomy.pdf
- Baldwin JL et al. (2005) · Anatomic dimensions of the patella measured during total knee arthroplasty.PubMed record · 92 patellae measured during TKA. Documents articular dimensions, ridge offset and unequal facets. Cohort averages are not a universal normal or the dimensions of this model.
- Better forgotten joint scores when the angle of the prosthetic trochlea is lateral to the quadriceps vector in kinematically aligned total knee arthroplasty.pdf
- Better PROMs with Lateralized Prosthetic Trochlea J Pers Med 2023.pdf
- Campi et al. (2026 · online 2025) · Kinematic alignment preserves the mid-flexion trochlear line orientation in total knee arthroplasty: A prospective analysis from the FP-UCBM Knee Study GroupPubMed record · 158 knees; mid-flexion trochlear line compared with the posterior condylar line. The facet-to-facet line is distinct from the longitudinal groove direction.
- Chronic lateral patella tracking is strongly associated with quadriceps external rotation in relation to the femoral shaft and not with wasting of the vastus medialis.pdf
- Coughlin-JOA03-tibial axis and patellar position relative to femoral epicondylar axis.pdf
- Differences in trochlear parameters between native and prosthetic kinematically or mechanically aligned knees.pdf
- Eckhoff-CORR97-Knee_Version_Associated_With_Anterior_Knee_Pain.20.pdf
- Effect of femoral component design and quadriceps load on patellofemoral kinematics after total knee arthroplasty.pdf
- Effects of Femoral Component Design on the Deepest Point Position of the Trochlear Groove in Kinematically Aligned Total Knee Arthroplasty.pdf
- Evidence of trochlear dysplasia in femoral component designs.pdf
- Gattu et al 2024 - Trochlear Comparisons - JOA.pdf
- Gattu et al. (2024 online) · Does contemporary total knee designs replicate the anatomy of the native trochlea?PubMed record · 37 healthy femora and 13 implant designs. Compares trochlear length, width, height, sulcus angle and direction. Geometric differences do not establish clinical superiority.
- Gender differences in trochlear groove orientation and rotational kinematics of human knees.pdf
- Gender differences in trochlear groove orientation and rotational kinematics of human knees.pdf
- Hofmann AA et al. (1997) · Patellar component medialization in total knee arthroplasty.PubMed record · 140 TKAs compared centered and medialized patellar components. The medialized group required fewer lateral releases. This historical, design-specific comparison does not establish a universal medialization distance.
- Howell-Knee Surg Sports Traumatol Arthros-2023.pdf
- Howell-KSSTA13-Variability of Tubercle (1).pdf
- Hull-JKS Trochlea Sphere 2022.pdf
- Hull, JKS, 2022_Differences in trochlear morphology from native using a femoral component interfaced.pdf
- Hungerford-CORR85-total knee arthroplasty (1).pdf
- Implant Trochlear Angles KSSTA 2023.pdf
- Incavo-JOA03-rotational relationships of the knee.pdf
- Iranpour F et al. (2008) · The width:thickness ratio of the patella: an aid in knee arthroplasty.PubMed record · 37 CT-reconstructed knees and 79 radiographs. Width and thickness were related. The study supports examining proportions; its ratio is not programmed as a surgical target.
- KA Design for PF Tracking J Pers Med 2023.pdf
- KA Recreates Trochlea Better Than MA JBB 2024.pdf
- KA TKA Deep Flexion PFJ KSST 2019.pdf
- KA Trochlear Anatomy Review KSST 2025.pdf
- Kafa B et al. (2024) · Evaluation of Patella Anatomy for Total Knee Arthroplasty Approaches.PubMed record · 168 anatomical patellae assessed with morphometry and Wiberg classification. Bone morphology cannot be treated as an MRI cartilage-surface measurement.
- Kinematic alignment more closely restores the groove location and the sulcus angle of the native trochlea than mechanical alignment.pdf
- Kinematic alignment of current TKA implants does not restore the native trochlear anatomy.pdf
- Kinematically aligned total knee arthroplasty reproduces native patellofemoral biomechanics during deep knee flexion.pdf
- Kinematically aligned total knee arthroplasty reproduces native patellofemoral biomechanics during deep knee flexion.pdf
- Klasan et al. (2024) · Trochlea morphology demonstrates variability but no gender difference in osteoarthritic patients undergoing total knee arthroplastyPubMed record · 200 arthritic knees assessed by CT. Median sulcus angle 137° (IQR 12°), lateral inclination 18° (IQR 7°). IQR values are widths, not normal limits, and are not used as slider bounds.
- Koh et al. (2019) · Gender-related morphological differences in sulcus angle and condylar height for the femoral trochlea using magnetic resonance imagingPubMed record · 975 Korean patients; MRI sections at 15°, 30° and 45°. Shape differences depend on the section and cohort; these are not universal male and female presets.
- Location of the femoral sulcus in the osteoarthritic knee.pdf
- Location of the femoral sulcus in the osteoarthritic knee.pdf
- Mismatch between trochlear coronal alignment of arthritic knees and currently available prosthesis- a morphological analysis of 4116 knees and 45 implant designs.pdf
- Mismatch between trochlear coronal alignment of arthritic knees and currently available prosthesis.pdf
- Modern TKA Design and PF Issues OTSR 2018.pdf
- Nedopil et al. (2017) · What clinical characteristics and radiographic parameters are associated with patellofemoral instability after kinematically aligned total knee arthroplasty?PubMed record · Matched case-control analysis of 13 patellofemoral instability cases among 3,212 KA knees; component flexion was associated with instability.
- Nicolet-Petersen, KSSTA, 2019_KA TKA restores physiological patellofemoral biomechanics.pdf
- Patellofemoral Joint Kinematics JOR 2009.pdf
- Patellofemoral joint kinematics- the circular path of the patella around the trochlear axis.pdf
- PF Instability Risk Factors in KA Int Ortho 2017.pdf
- Picken S et al. (2022) · Inter- and intra-observer reliability of patellar height measurements in patients with and without patellar instability on plain radiographs and magnetic resonance imaging.PubMed record · 44 instability patients and 50 controls. Patellar-height measurements differed between radiographs and MRI. Specify the landmarks, method and modality before comparing values.
- Poor relationship between frontal tibiofemoral and trochlear anatomic parameters- Implications for designing a trochlea for kinematic alignment.pdf
- Preoperative quadriceps malalignment is associated with poor outcomes after knee replacement which are avoided by external rotation of the femoral component.pdf
- Quadriceps tendon malalignment is an independent anatomical deformity which is the primary abnormality associated with lateral facet patellofemoral joint osteoarthritis.pdf
- Referencing the sulcus line of the trochlear groove and removing intraoperative parallax errors improve femoral component rotation in total knee arthroplasty.pdf
- Restoration of the trochlear peaks is unnecessary with a kinematic alignment-optimized femoral component, as under-stuffing results.pdf
- retrieve.pdf
- Rotational Malalignment of the Extensor Mechanism.pdf
- Sexual and ethnic polymorphism result in considerable mismatch between native trochlear geometry and off-the-shelf TKA prostheses.pdf
- Shah NS et al. (2022) · Patellar Morphology and Osteoarthritis: A Cadaveric Analysis.PubMed record · 1,032 cadaveric patellae. Facet-length ratios were more reproducible than Wiberg typing, but did not correlate with arthritis. A width ratio alone does not establish a Wiberg type or predict arthritis.
- Shih, Bull and Amis (2004) · The cartilaginous and osseous geometry of the femoral trochlear groovePubMed record · 33 cadaveric knees. Cartilage and bone geometry differ, and the sulcus changes along the trochlea. Specify which surface and location are measured.
- Sulcus morphology of the distal femur.pdf
- sulcus_morphology_of_the_distal_femur.4.pdf
- Tammachote N et al. (2023) · Do we need to restore patellar thickness after total knee arthroplasty with patellar resurfacing?PubMed record · 220 retrospectively studied TKAs. Modest added thickness in one resurfacing technique was not associated with worse flexion or WOMAC results versus patelloplasty. This is not proof that any amount of overstuffing is safe.
- Tanifuji-CORR13-vector of quadriceps pull is directed from the patella to the femoral neck.pdf
- Tanifuji-CORR13-vector of quadriceps pull is directed from the patella to the femoral neck.pdf
- The effects of axial rotational alignment of the femoral component on knee stability and patellar tracking in total knee arthroplasty.pdf
- The geometry of the trochlear groove.pdf
- The Quadriceps Vector in the Lower Extremity of Indian Patients Is Similar in Caucasian and Japanese Patients.pdf
- The sulcus line of the trochlear groove is more accurate than Whiteside's Line in determining femoral component rotation.pdf
- The tibial cut influences the patellofemoral knee kinematics and pressure distribution in total knee arthroplasty with constitutional varus alignment.pdf
- The tibial cut influences the patellofemoral knee kinematics and pressure distribution in total knee arthroplasty with constitutional varus alignment.pdf
- The trochlear sulcus of the native knee is consistently orientated close to the sagittal plane despite variation in distal condylar anatomy.pdf
- The Vector of Quadriceps Pull is Directed From the Patella to the Femoral Neck.pdf
- Tibial axis and patellar position relative to the femoral epicondylar axis during squatting.pdf
- Tibial axis and patellar position relative to the femoral epicondylar axis during squatting.pdf
- TKA TKA Deep Flexion PFJ KSST 2020.pdf
- Trochlear Angles Implant Designs JOA 2023.pdf
- Trochlear Differences in Native, KA, and MA Knees KSST 2018.pdf
- Trochlear Implant Morphology Bioengineering 2025.pdf
- Trochlear Morphology KA vs MA J Knee Surg 2020.pdf
- Undercoverage of lateral trochlear resection is correlated with the tibiofemoral alignment parameters in kinematically aligned total knee arthroplasty.pdf
- van Meijeren et al 2026 - Alignment and the Patellofemoral Joint - The Knee.pdf
- Variations in trochlear morphology of contemporary and legacy total knee arthroplasty prostheses- a review of 22 designs.pdf
- Wang et al. (2012) · The 3D analysis of the sagittal curvature of the femoral trochlea in the Chinese populationPubMed record · 100 healthy Chinese knees. Medial facet, lateral facet and groove have separately fitted sagittal curvatures; a single universal radius is not assumed.
- What clinical characteristics and radiographic parameters are associated with patellofemoral instability after kinematically-aligned total knee arthroplasty.pdf
- Wide variation in tibial slopes and trochlear angles in the arthritic knee- a CT evaluation of 4116 pre-operative knees.pdf
- Wide Variation of Slope of PFA KSST 2022.pdf
- WJO-5-163.pdf
- Yu et al. (2025) · Failure to Restore Normal Trochlear Orientation Does Not Affect Postoperative Patella-Related Outcomes in Robotic-Assisted Functional Alignment Total Knee ArthroplastyPubMed record · 110 retrospective robotic functional-alignment TKAs. Geometry and clinical outcomes are different endpoints; this study does not validate the model or prove all orientations equivalent.
Implant design & polyethylene geometry40 references
- A best-fit of an anatomic tibial baseplate closely parallels the flexion-extension plane and covers a high percentage of the proximal tibia.pdf
- A best-fit of an anatomic tibial baseplate closely parallels the flexion-extension plane and covers a high percentage of the proximal tibia.pdf
- A medial congruent polyethylene offers satisfactory early outcomes and patient satisfaction in total knee arthroplasty.pdf
- A prospective randomized controlled trial comparing medial-pivot versus posterior-stabilized total knee arthroplasty.pdf
- A retrospective comparison of a medial pivot and posterior-stabilized total knee arthroplasty with respect to patient-reported and radiographic outcomes.pdf
- Better flexion and early recovery with medial-stabilized.pdf
- Clinical and patient-reported outcomes of medial stabilized versus non-medial stabilized prostheses in total knee arthroplasty- a systematic review and meta-analysis.pdf
- Comparative study on mid- and long-term clinical effects of medial pivot prosthesis and posterior-stabilized prosthesis after total knee arthroplasty.pdf
- Comparison of the clinical and patient-reported outcomes between medial stabilized and posterior stabilized total knee arthroplasty.pdf
- Ettinger et al. (2024) · Higher satisfaction and function scores in restricted kinematic alignment versus mechanical alignment with medial pivot design total knee arthroplasty: A prospective randomised controlled trial.PubMed record · 98-patient restricted-KA versus MA randomized trial with a medial-pivot implant and patient-specific instruments; early joint awareness favored rKA.
- French-JOA20-Medial Stabilized versus CR in KA TKA.pdf
- Higher satisfaction and function scores in restricted kinematic alignment versus mechanical alignment with medial pivot design total knee arthroplasty.pdf
- Howell-Knee Surg Sports Traumatol Arthros-2023.pdf
- Hull-KSSTA Persona, A-2022 copy.pdf
- Implant design may influence knee flexor activation patterns during stair ascent and descent.pdf
- Kinematically aligned total knee arthroplasty using medial pivot knee prosthesis enhances medial pivot motion.pdf
- Koutp et al. (2026) · Unrestricted kinematic alignment offers limited functional benefit over mechanical alignment in medial pivot total knee arthroplasty: A randomized controlled trial using conventional instrumentation.PubMed record · 100 analyzed patients at 2 years; several scores favored KA, but most differences did not exceed reported clinical-importance thresholds. Published online in 2025.
- Medial Congruent and Medial Pivot Inserts in Total Knee.pdf
- Medial stabilised total knee arthroplasty achieves comparable clinical outcomes when compared to other TKA designs- a systematic review and meta-analysis of the current literature.pdf
- medial_pivot_designs_versus_conventional_bearing.6.pdf
- Mid-flexion stability in the anteroposterior plane is achieved with a medial congruent insert in cruciate retaining total knee arthroplasty for varus osteoarthritis.pdf
- Nedopil- JPM Lat Congruency 2022.pdf
- Nedopil-J knee Surg 2021.pdf
- No clinical differences at the 2-year follow-up between single radius and J-curve medial pivot total knee arthroplasty in the treatment of neutral or varus knees.pdf
- No difference in patient preference for medial pivot versus posterior-stabilized design in staged bilateral total knee arthroplasty.pdf
- No kinematical difference between ultra-congruent and medial-congruent total knee arthroplasty when implanted with mechanical alignment.pdf
- Outcomes are better with a medial-stabilized vs a posterior-stabilized total knee implanted with kinematic alignment.pdf
- Outcomes are Better With a Medial-Stabilized vs a Posterior-Stabilized Total Knee Implanted With Kinematic Alignment.pdf
- Petersen - Medial congruent polyethylene design show different tibiofemoral.pdf
- Risitano et al 2020 - KA and MP Designs - J Ortho.pdf
- Short-term follow-up of kinematically vs. mechanically aligned total knee arthroplasty with medial pivot components- a case-control study.pdf
- Short-term follow-up of kinematically vs. mechanically aligned total knee arthroplasty with medial pivot components.pdf
- The posterolateral upslope of a low-conforming insert blocks the medial pivot during a deep knee bend in TKA.pdf
- The posterolateral upslope of a low-conforming insert blocks the medial pivot during a deep knee bend in TKA.pdf
- The posterolateral upslope of a low-conforming insert blocks the medial pivot during a deep knee bend in TKA.pdf
- Tibiofemoral kinematic analysis of knee flexion for a medial pivot knee.pdf
- Unrestricted kinematic alignment offers limited functional benefit over mechanical alignment in medial pivot total knee arthroplasty.pdf
- Unrestricted kinematic alignment offers limited functional benefit over mechanical alignment in medial pivot total knee arthroplasty.pdf
- Wang et al 2026 - J Clin Med.pdf
- Zhang et al 2025 - MA vs KA in rTKA - J Ortho.pdf
Surgical technique & instrumentation20 references
- A surgeon that switched to unrestricted kinematic alignment with manual instruments has a short learning curve and comparable resection accuracy.pdf
- Accuracy of matching tibial slope in manual kinematically aligned total knee arthroplasty.pdf
- Caliper-verified unrestricted kinematically aligned total knee arthroplasty in Asian patients showed efficacious mid- to long-term results regardless.pdf
- Changes in varus and valgus slope caused by tibial cutting block rotation in total knee arthroplasty.pdf
- Does a positioning rod or a patient-specific guide result in more natural femoral flexion in the concept of kinematically aligned total knee arthroplasty.pdf
- Does calipered kinematically aligned TKA restore native left to right symmetry of the lower limb and improve function.pdf
- Does Calipered Kinematically Aligned TKA Restore Native Left to Right Symmetry of the Lower Limb and Improve Function.pdf
- Femoral cartilage variability affects the accuracy of kinematic alignment and imageless navigation in total knee arthroplasty- A prospective study from the FP-UCBM Knee Study Group.pdf
- Howell-KSSTA-2022 accuracy copy.pdf
- Howell-KSSTA-2022 accuracy.pdf
- Improving Accuracy in Knee Arthroplasty.pdf
- Measured resection techniques do not align to the cylindrical axis in kinematic total knee arthroplasty.pdf
- Mechanical and kinematic alignment in total knee arthroplasty- a comparative study on sizing discrepancies.pdf
- Nedopil JPM learning curve 2022.pdf
- Nedopil-The Knee-2023.pdf
- Negligible effect of surgeon experience on the accuracy and time to perform unrestricted caliper-verified kinematically aligned TKA with manual instruments.pdf
- Outcomes in Patients with a Calipered Kinematically Aligned TKA That Already Had a Contralateral Mechanically Aligned TKA.pdf
- Shelton-2019-Outcomes-in-patients-with-a-caliper copy.pdf
- The viability and success of cementless kinematic total knee arthroplasty.pdf
- Use-the-Right-Looking-Glass-When-You-Do-Caliper-verified-K_2022_Arthroplasty.pdf
Component rotation & positioning7 references
- Akogi-CORR04-An_Anteroposterior_Axis_of_the_Tibia_for_Total.30.pdf
- Can kinematic tibial templates assist the surgeon in locating the flexion and extension plane of the knee.pdf
- changes-in-the-rotational-axes-of-the-tibiofemoral-joint-caused-by-resection.pdf
- changes-in-the-rotational-axes-of-the-tibiofemoral-joint-caused-by-resection.pdf
- Nakahara-Knee15-rotational align of tibial component affects kinematic rotation of WB after TKA.pdf
- The high variability of tibial rotational alignment in total knee arthroplasty.pdf
- Variability of the location of the tibial tubercle affects the rotational alignment of the tibial component in kinematically aligned total knee arthroplasty.pdf
Comparative studies33 references
- Calliess-Knee Surg Sports Traumatol Arthr-2017.pdf
- Calliess-KSSTA17-KA versus MA-RCT.pdf
- Calliess-KSSTA17-kinematic vs mechanical alignment tka.pdf
- Dossett_Bone Joint J_2014.pdf
- Dossett-J Arthroplasty-2023.pdf
- Elbuluk-J Arthroplasty-2022 copy.pdf
- French-J Arthroplasty-2020.pdf
- Head-to-Head Comparison of Kinematic Alignment Versus Mechanical Alignment for Total Knee Arthroplasty.pdf
- Howell KA vs MA OrthoToday 102010.pdf
- Jamali et al. (2024) · Kinematic versus mechanical alignment: A systematic review of systematic reviews and meta-analyses of randomised controlled trials.PubMed record · Review of 18 evidence syntheses identifies mixing of techniques, follow-up times and duplicate patients.
- Jeremic-Orthop Traumatol Surg Res-2020 copy.pdf
- Kinematic Alignment Does Not Result in Clinically Important Improvements After TKA Compared With Mechanical Alignment- A Meta-analysis of Randomized Trials.pdf
- Kinematic Alignment Does Not Result in Clinically Important Improvements After TKA Compared With Mechanical Alignment.pdf
- Kinematic alignment versus mechanical alignment in primary total knee arthroplasty- an updated meta-analysis of randomized controlled trials.pdf
- Kinematically versus mechanically aligned total knee arthroplasty.pdf
- MacDessi-Bone Joint J-2020.pdf
- Matsumoto-BJJ17-radiological and clinical compar KA vs MA.pdf
- Matsumoto-Bone & Joint Journal-2017.pdf
- McEwen-J Arthroplasty-2020.pdf
- Niki-J Arthroplasty-2020.pdf
- Nucci et al. (2025) · Kinematic Alignment Does Not Result in Clinically Important Improvements After TKA Compared With Mechanical Alignment: A Meta-analysis of Randomized Trials.PubMed record · RCT meta-analysis interpreted against clinical-importance thresholds; pooled functional score combined Oxford with converted WOMAC.
- Patients undergoing staged bilateral knee arthroplasty are less aware of their kinematic aligned knee compared to their mechanical knee.pdf
- PSI kinematic versus non-PSI mechanical alignment in total knee arthroplasty- a prospective, randomized study.pdf
- Radiological and clinical comparison of kinematically versus mechanically aligned total knee arthroplasty.pdf
- Radiological and clinical comparison of kinematically versus mechanically aligned total knee arthroplasty.pdf
- Scott-J Arthroplasty-2022 copy.pdf
- Shelton-The Journal of Knee Surgery-2019.pdf
- The early outcome of kinematic versus mechanical alignment in total knee arthroplasty- a prospective randomised control trial.pdf
- Waterson-BJJ16-Early Outcome of KA vs MA TKA-RCT.pdf
- Waterson-Bone Joint J-2016.pdf
- Yaron-J Orthop-2021 copy.pdf
- Young-2016-The Chitranjan S. Ranawat Award _ N.pdf
- Young-CORR16-no difference at 2 years KA vs MA-RCT.pdf
Patient outcomes & recovery25 references
- 155756-in-my-experience-my-20-year-kinematic-alignment-journey-how-it-led-to-a-ka-optimized-implant-and-a-forgotten-joint-score-similar-to-anterior-hip-a.pdf
- A randomised controlled trial of kinematically and mechanically aligned total knee replacements- two-year clinical results.pdf
- A single surgeon series comparing the outcomes of a cruciate retaining and medially stabilized total knee arthroplasty using kinematic alignment principles.pdf
- A single surgeon series comparing the outcomes of a cruciate retaining and medially stabilized total knee arthroplasty using kinematic alignment principles.pdf
- Bauer et al. (2026) · No differences in functional and clinical outcomes after rehabilitation between modified kinematic and mechanical alignment in total knee arthroplasty: A randomized controlled trial.PubMed record · Navigation-assisted modified KA trial, 100 patients; no detected clinical or gait advantage at one year.
- Bosco et al 2025 - Clinical outcomes of KA in MP Knees - Systematic Review - J Exp Ortho.pdf
- Comparison of Kinematic Alignment and Mechanical Alignment in Total Knee Arthroplasty.pdf
- COMPON~1.PDF
- Component alignment during total knee arthroplasty with use of standard.pdf
- Computer-assisted kinematic and mechanical axis total knee arthroplasty- a prospective randomized controlled trial of bilateral simultaneous surgery.pdf
- Gibbons et al. (2025) · No Difference in 10-year Clinical or Radiographic Outcomes Between Kinematic and Mechanical Alignment in TKA: A Randomized Trial.PubMed record · 99 randomized patients; no detected PROM or revision-survival difference at 10 years.
- Is There a Force Target That Predicts Early Patient-reported Outcomes After Kinematically Aligned TKA.pdf
- Joint Line Modification in Kinematically Aligned Total Knee Arthroplasty Improves Functional Activity but Not Patient Satisfaction.pdf
- Kinematic alignment results in clinically similar outcomes to mechanical alignment- systematic review and meta-analysis.pdf
- Kinematic Alignment Technique Outperforms Mechanical Alignment in Simultaneous Bilateral Total Knee Arthroplasty-A Randomized Controlled Trial.pdf
- Kinematically aligned total knee arthroplasty did not show superior patient-reported outcome measures.pdf
- Limitations of the Knee Society Score in kinematically aligned total knee arthroplasty.pdf
- Medially congruent total knee arthroplasty in valgus knee deformities yields satisfactory outcomes- a multicenter, international study.pdf
- Niki-JOA20-KA Athroplasty-Perspectives on PROMs.pdf
- Outcomes of manual kinematic alignment total knee arthroplasty in valgus knee deformity.pdf
- Setting the distal and posterior condyle of the femoral component to restore the medial pre-arthritic femoral articular surface results.pdf
- Shelton-JournalofKnee19-Outcomes of patients with MA and KA knees.pdf
- The Forgotten Joint Score after total knee arthroplasty with a kinematic alignment-optimized femoral component matches total hip arthroplasty.pdf
- Vermue et al. (2025) · Rotating-platform deep-dish total knee arthroplasty with restricted kinematic alignment: Five-year clinical and functional outcomes.PubMed record · Restricted KA rotating-platform deep-dish cohort; 123 of 143 patients followed at five years; reported revision-free survival 98%.
- Who Will Benefit From Kinematically Aligned Total Knee Arthroplasty- Perspectives on Patient-Reported Outcome Measures.pdf
Implant survivorship & complications20 references
- A new tibial insert design with ball-in-socket medial conformity and posterior cruciate ligament retention has low tibial baseplate migration.pdf
- A randomized controlled trial of tibial component migration with kinematic alignment using patient-specific instrumentation versus mechanical alignment.pdf
- Dossett-J Arthroplasty-2023 copy.pdf
- Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements.pdf
- Howell et al. (2018) · Implant Survival and Function Ten Years After Kinematically Aligned Total Knee Arthroplasty.PubMed record · 222 knees in a single-surgeon series; 97.5% survival free of revision for any reason at 10 years.
- Howell et al. (2024) · Reoperation, Implant Survival, and Clinical Outcome After Kinematically Aligned Total Knee Arthroplasty: A Concise Clinical Follow-Up at 16 Years.PubMed record · Same 222-knee cohort; 93% survival with any reoperation as the endpoint. Published online in 2023.
- Howell-The Journal of Arthroplasty-2018 copy.pdf
- Howell, J Arthro, 2023.pdf
- Kinematically aligned total knee arthroplasty is as effective in severe varus deformities as in mild deformities.pdf
- Klasan-The Journal of Arthroplasty-2020 copy.pdf
- Laende Dunbar 2019 BJJ - KATKA & RSA.pdf
- Laende et al. (2019) · A randomized controlled trial of tibial component migration with kinematic alignment using patient-specific instrumentation versus mechanical alignment using computer-assisted surgery in total knee arthroplasty.PubMed record · 47 randomized knees; no detected difference in tibial migration at 2 years; an early fixation surrogate.
- Laende-Bone Joint J-2019 copy.pdf
- Niesen KSSTA RSA 2022 copy.pdf
- Niesen KSSTA RSA 2022.pdf
- Niesen-JBJS-Submitted JBJS May 2023 copy.pdfFilename identifies a submitted manuscript; publication status has not been verified.
- Shekhar, JPM MUA 2022.pdf
- Similar migration for medial congruent and cruciate-retaining tibial components in an anatomic TKA system.pdf
- Tran et al. (2022) · Kinematic alignment in total knee arthroplasty: a five-year prospective, multicentre, survivorship study.PubMed record · 100-patient multicentre series; five-year clinical follow-up with additional registry surveillance; patellar revisions warrant attention.
- What mechanisms are associated with tibial component failure after kinematically-aligned total knee arthroplasty.pdf
General reference & perspectives109 references
Broader reference material and papers whose filenames do not identify a specific subject. Topics are based on available filenames and collection labels, not a full-text review.
- 00004623-201510210-00006.pdf
- 0301-620x.82b8.0821189.pdf
- 0301-620x.82b8.0821196.pdf
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- 1-s2.0-S0261306908001647-main.pdf
- 1-s2.0-S0883540319305200.pdf
- 1-s2.0-S0883540322002364.pdf
- 1-s2.0-S0883540322002364.pdf
- 1-s2.0-S0968016021000041.pdf
- 1-s2.0-S1877056813001072-main.pdf
- 3580-PB8-9115-R3.pdf
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- Barad-Arthroplast Today-2018.pdf
- Bonny, JBME, 2013 copy.pdf
- Brar, J Arthroplasty, 2016.pdf
- Campanelli-Computer Methods in Biomechani-2019.pdf
- Delman-Knee Surg Sports Traumato-In Press 2021.pdf
- Dhaliwal-Journal of Personalized Medicine-2022.pdf
- Dhaliwal-Journal of Personalized Medicine-2022.pdf
- Dossett et al. (2014) · A randomised controlled trial of kinematically and mechanically aligned total knee replacements: two-year clinical results.PubMed record · 88 randomized knees; early pain, function and flexion favored KA with patient-specific guides.
- Dossett et al. (2023) · A Randomized Controlled Trial of Kinematically and Mechanically Aligned Total Knee Arthroplasties: Long-Term Follow-Up.PubMed record · Same original 88-patient trial at a mean 13 years; no detected PROM or reoperation difference; substantial attrition.
- Dossett-J Arthroplasty-2023.pdf
- eor-4-519.pdf
- Ettinger-Der Orthopäde-2020.pdf
- Ettinger, AOTS, 2016.pdf
- Freeman 2005.pdf
- Galinat9781975201388-ch020.pdf
- Gu-J Orthop Res-2016 copy.pdf
- Gu, JBJS, 2014.pdf
- Hirschmann-Knee Surgery, Sports Traumatol-2019.pdf
- Howell-Instructional course lectures-2023.pdf
- Howell-Knee Surgery, Sports Traumatology-2020.pdf
- Howell-Knee Surgery, Sports Traumatology-2020.pdf
- Howell-letter to Editor, JBJS, 2010.pdf
- Howell-Orthopedics-2019 re.pdf
- Howell-The Journal of Arthroplasty-2018.pdf
- Howell, Arthropedia, 2014 .pdf
- Howell, CORR, 2010.pdf
- Howell, CORR, 2012.pdf
- Howell, Int Orthop, 2015.pdf
- Howell, JBJS 2010.pdf
- Howell, JBJS, 2012.pdf
- Howell, JBJS, Appendix 2010.pdf
- Howell, KSSTA, 2012.pdf
- Howell, KSSTA, 2013.pdf
- Howell, OKO, 2012.pdf
- HOwell, Ortho, Article, 2010.pdf
- Howell, Orthop, 2008 .pdf
- Howell, Orthop, 2009.pdf
- Howell, Thienpont Chapter, 2012.pdf
- Hull-J Knee Surg-2020.pdf
- Hull-Journal of Biomechanics-2019.pdf
- Hull-KSSTA Persona, A-2022.pdf
- Hull, JB, 2019_Does the lift.pdf
- Hungerford-CORR83-Preliminary_Experience_with_a_Total_Knee.12.pdf
- Hungerford-CORR83-Preliminary_Experience_with_a_Total_Knee.12.pdf
- Hungerford-CORR85-total knee arthroplasty.pdf
- In My Experience- Transformation from Medial UKA to Medial Sphere KA- Where the Data Leads.pdf
- Johnson, CORR, 2013.pdf
- jpm-12-01724.pdf
- KA_Reference_Library_Abstract_Technical_Summary.pdf
- Kim-Yonsei Med J-2020.pdf
- Klasan et al. (2020) · Similar Risk of Revision After Kinematically Aligned, Patient-Specific Instrumented Total Knee Arthroplasty, and All Other Total Knee Arthroplasty: Combined Results From the Australian and New Zealand Joint Replacement Registries.PubMed record · 20,512 knees with the same implant design, including 416 KA-PSI; similar cumulative revision at 7 years.
- Lee-Knee Surg Sports Traumatol Arthrosc-2017.pdf
- Lozano-Comput Methods Biomech Biomed Engi-2019.pdf
- Lozano, KSSTA, 2018.pdf
- Nam, CORR, review.pdf
- Nam, KSSTA, 2014 copy.pdf
- Nam, KSSTA, 2014.pdf
- Nedopil-2021-Restoring-the-patients-pre-arthriti.pdf
- Nedopil-Int Orthop-2017 copy.pdf
- Nedopil-Int Orthop-2017.pdf
- Nedopil-J Arthroplasty-2018 copy.pdf
- Nedopil-J Arthroplasty-2018.pdf
- Nedopil-J Knee Surg-2020.pdf
- Nedopil-Journal of Personalized Medicine-2021.pdf
- Nedopil-Knee Surg Sports Traumatol Arthro-2019.pdf
- Nedopil-Personalized Hip and Knee Joint R-2020.pdf
- Nedopil-Tibial Comp-Int Orthop-2017 copy.pdf
- Nedopil-Tibial Comp-Int Orthop-2017.pdf
- Nedopil, ISAKOS, 2017.pdf
- Nedopil, Ortho, 2013.pdf
- Nepdopil, CONA, 2016.pdf
- Nicolet-Peterse-Knee Surg Sports Traumato-2019.pdf
- Niesen-Journal of Biomechanics-2020.pdf
- Niesen-Journal of Biomechanics-2022.pdf
- nihms904733.pdf
- Nunley, CORR, 2011.pdf
- Pachos, Knee, 2017.pdf
- Rak-Journal of Personalized Medicine-2023.pdf
- Ross, J Biomech, 2017.pdf
- s00167-022-07206-w.pdf
- Sappey-Marinier-Journal of Personalized M-2022 copy.pdf
- Schutz-J Orthop Res-2019.pdf
- Scott, Ortho Today, 2019.pdf
- Shelton-Bone Joint J-2017 copy.pdf
- Shelton-Journal of Knee Surgery-In Press, 2019.pdf
- Shelton-The Journal of Knee Surgery-2019.pdf
- Shelton, CORR, 2018 copy 2.pdf
- Shelton, CORR, 2018 copy.pdf
- Shelton, J Knee Surg KA MA, 2019 copy.pdf
- Singh-Archives of Orthopaedic and Trauma-2017.pdf
- Singh, AOTS, 2017.pdf
- Smith, JOA, 2010.pdf
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- Thienport_Knee_2013.pdf
- Varus Knee Chapter Shelton 2018.pdf
- Vernace, CHAPTER 54, Parvizi, 2012.pdf
- Wang et al. (2024) · Superiority of kinematic alignment over mechanical alignment in total knee arthroplasty during medium- to long-term follow-up: A meta-analysis and trial sequential analysis.PubMed record · Seven-RCT synthesis separates medium- and long-term results; cohort overlap with individual trial reports means it is not additional independent patient data.
PubMed records open on PubMed. PDFs open at their original location with existing access permissions. Some require an authorized Microsoft account; inclusion here does not grant access.
This library includes research articles and supporting reading. Inclusion is not an endorsement of a study’s conclusions; filenames are not verified citations.
Polyethylene
1,876 references · 711 PDF links
Knee insert design: medial congruence, medial stabilization and constraint, with related bearing designs listed separately.
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Collection scope and sources
Imported from the supplied knee insert reference collection, compiled September 11, 2026. Citations and design tags are preserved from that collection. Its search covers PubMed/MEDLINE; categories reflect indexed terms and are not a full-text assessment of each paper.
PDF links open the original publisher or repository locations recorded in the supplied collection, which identifies these papers as open access. Availability is controlled by those sources. References without a downloaded PDF retain their publisher and database links. Inclusion does not establish clinical superiority.
Collection methods ↗ · Open-access papers without a downloaded PDF ↗Presentations and cases
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Educational contributions are not peer-reviewed guidance or a substitute for clinical judgment. Contributor names and credentials are self-reported. External links retain their own access settings.
Selected reading
Medial stabilization.
16 papers on bearing geometry, measured motion, and clinical outcomes. Reviews may include the primary studies listed here.
Motion · Moonot et al. · 2009Tibiofemoral kinematic analysis of knee flexion for a medial pivot knee
Fluoroscopy · 13 patients / 15 knees
Medial-centered motion during lunge and kneeling, with less tibial rotation than reported for native knees.
Small, activity-specific series; no comparative patient-outcome claim.
Read published paper ↗Outcomes · Scott & Gray · 2022Outcomes are Better With a Medial-Stabilized vs a Posterior-Stabilized Total Knee Implanted With Kinematic Alignment
Randomized trial · 200 patients · KA · 2 years
MS had greater maximum flexion (132° vs 124°) and a higher Forgotten Joint Score (68.3 vs 58.3).
Single center and specific implant systems. Not every enrollee completed every two-year measure; results do not isolate the polyethylene alone.
Read published paper ↗Motion · Alesi et al. · 2022No kinematical difference between ultra-congruent and medial-congruent total knee arthroplasty when implanted with mechanical alignment
Dynamic RSA · 8 MC / 8 UC · MA
No detected difference in medial-pivot behavior during sit-to-stand; clinical flexion was greater with MC.
Small sample; absence of a detected difference is not proof of equivalence.
Read published paper ↗Outcomes · Hoskins et al. · 2022Medial Pivot Designs Versus Conventional Bearing Types in Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Systematic review · 8 randomized trials · 725 knees
Pooled MP-versus-PS comparisons found no clear advantage in measured clinical outcomes.
One high-risk-of-bias trial excluded from pooling; insufficient randomized evidence for other bearing comparisons.
Read published paper ↗Overview · Romano et al. · 2025Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping Review
Scoping review · 39 articles · 6,143 TKAs
Generally favorable outcomes with both MC and MP constructs; terminology and surgical approaches vary.
Heterogeneous evidence does not establish equivalence, a universal PCL strategy, or comparative longevity.
Read published paper ↗Motion · Nelson-Tranum et al. · 2025Implant design may influence knee flexor activation patterns during stair ascent and descent
Biomechanics and EMG · 52 patients · 1 year
Greater medial AP constraint was associated with lower biceps femoris activation during stair tasks.
Muscle activation is not proof of easier stairs, reduced fatigue, or superior patient outcomes.
Read published paper ↗Outcomes · French et al. · 2020A Single Surgeon Series Comparing the Outcomes of a Cruciate Retaining and Medially Stabilized Total Knee Arthroplasty Using Kinematic Alignment Principles
Prospective comparison · 90 patients · KA · 1 year
Higher FJS and selected quality-of-life scores with MS; most other measures were comparable.
Small, nonrandomized, single-surgeon comparison with short follow-up.
Read published paper ↗Outcomes · Jones et al. · 2023Better flexion and early recovery with medial-stabilized vs single-radius total knee arthroplasty with kinematic alignment: Two-year clinical results
Retrospective cohort comparison · 210 patients · KA
MS had greater flexion from six months to two years and selected early pain advantages.
Comparison across separate trials, not a direct randomized comparison. The MS cohort overlaps the Scott–Gray trial.
Read published paper ↗Outcomes · Chang et al. · 2021A Prospective Randomized Controlled Trial Comparing Medial-Pivot versus Posterior-Stabilized Total Knee Arthroplasty
Randomized trial · 88 patients · 2 years
No detected differences in ROM or measured patient-reported outcomes between MP and PS.
Findings apply to the studied devices and follow-up; no significant difference does not establish equivalence.
Read published paper ↗Motion · Tsubosaka et al. · 2021Mid-flexion stability in the anteroposterior plane is achieved with a medial congruent insert in cruciate-retaining total knee arthroplasty for varus osteoarthritis
Intraoperative comparison · 30 varus OA knees · CR-TKA
MC reduced AP translation under manual stress at 45° compared with CR inserts. Varus–valgus laxity was comparable.
Intraoperative mechanics, not evidence that MC prevents long-term clinical instability.
Read published paper ↗Motion · Kaneda et al. · 2022Kinematically Aligned Total Knee Arthroplasty Using Medial Pivot Knee Prosthesis Enhances Medial Pivot Motion
Comparative kinematics · 13 knees / 9 patients · 1 year
KA knees showed greater lateral posterior travel and femoral external rotation than MA knees with the studied MP implant.
Exploratory: 8 KA and 5 MA knees. Does not establish clinical superiority.
Read published paper ↗Outcomes · Tso et al. · 2021Clinical and Patient-Reported Outcomes of Medial Stabilized Versus Non-Medial Stabilized Prostheses in Total Knee Arthroplasty: A Systematic Review and Meta-Analysis
Systematic review · 21 studies / 13 pooled
FJS favored MS by 13.83 points, just below the review’s chosen clinical-importance threshold of 14; other differences were absent or not clinically important.
Thresholds and study populations vary; statistical significance alone is not clinical importance.
Read published paper ↗Outcomes · Frye et al. · 2021A Medial Congruent Polyethylene Offers Satisfactory Early Outcomes and Patient Satisfaction in Total Knee Arthroplasty
Retrospective cohort · 327 TKAs · 1 year
MC improved selected early pain, FJS, and satisfaction measures; KOOS/PROMIS and MC-versus-PS satisfaction were similar.
Observational, short-term evidence; does not establish a universal satisfaction advantage.
Read published paper ↗Motion · Schütz et al. · 2019Kinematic Evaluation of the GMK Sphere Implant During Gait Activities: A Dynamic Videofluoroscopy Study
Dynamic fluoroscopy · 3 groups of 10 patients
The studied Sphere construct limited medial AP excursion while permitting lateral travel and axial rotation.
Selected good-outcome patients and specific devices; industry-supported study.
Read published paper ↗Motion · Delman et al. · 2021The posterolateral upslope of a low-conforming insert blocks the medial pivot during a deep knee bend in TKA: a comparative analysis of two implants with different insert conformities
Bilateral comparison · 25 patients · KA
The medial ball-in-socket/flat lateral construct maintained a medial pivot. A posterolateral upslope was proposed to explain different motion with the low-conforming CR construct.
Different implant systems, PCL management, and follow-up. No difference in median patient-reported outcomes.
Read published paper ↗Motion · Gray et al. · 2020Comparison of posterior-stabilized, cruciate-retaining, and medial-stabilized knee implant motion during gait
Randomized implant groups · gait imaging · 74 patients
MS showed less AP drawer/paradoxical translation and a medial center of rotation.
All three implant designs still differed from healthy knees. Motion is not a patient-outcome measure.
Read published paper ↗Implant selection · focused reading
Design differences and clinical outcomes
Ten primary studies selected for the three evidence views. Several also appear in the existing polyethylene library; these are curated comparisons, not ten new independent datasets.
Randomized clinical comparison · Less drawer at 30°; no detected PROM advantage
The Effect of Implant Design on Sagittal Plane Stability: A Randomized Trial of Medial- versus Posterior-Stabilized Total Knee Arthroplasty
Edelstein AI, Bhatt S, Wright-Chisem J, Sullivan R, Beal M, Manning DW.
J Knee Surg · 2020 May
PubMed ↗ · Published article ↗Medial-stabilized vs posterior-stabilized TKA · 50 patients analyzed (25 per group) · 2 years · KT-1000 arthrometer
Mean sagittal laxity at 30° was 5.6 vs 10.2 mm (P < .0001). At 90°, the difference was not significant (4.1 vs 5.3 mm; P = .14). Standard patient-reported scores did not differ.
Small trial. Laxity at one angle is not a clinical instability rate. Results do not identify a universal stability target or rank current company products.
Randomized groups · in-vivo motion · A medial center of rotation during walking
Comparison of posterior-stabilized, cruciate-retaining, and medial-stabilized knee implant motion during gait
Gray HA, Guan S, Young TJ, Dowsey MM, Choong PF, Pandy MG.
J Orthop Res · 2020 Aug
PubMed ↗ · Published article ↗MS (26), PS (23), and CR (25) knees · 74 patients · biplane X-ray imaging during a walking cycle
MS showed less AP drawer and paradoxical anterior translation, with a medial rather than lateral center of rotation. All three groups still differed from healthy knees.
Task-specific kinematics do not establish better pain relief, satisfaction, or implant survival. Our model does not replay the measured trajectories.
Laboratory · cadaveric · Geometry changes laxity in a controlled test
Total knee replacement designs have differing stability under novel robotic testing method in vitro
Holthof SR, Nejima S, Rock M, vanArkel RJ, Brivio A, Barrett D, Amis AA.
Knee Surg Sports Traumatol Arthrosc · 2025 Nov
PubMed ↗ · Published article ↗Modified designs based on ATTUNE MS, Persona MC, and symmetrical Triathlon · 8 cadaveric knees · same bone cuts · robotic loading: 710 N compression and ±90 N drawer
The single-radius symmetrical design had a larger mean AP laxity envelope than the other tested designs and native knees. Rollback did not differ significantly.
DePuy-funded study using modified test implants. This is not a trial of Triathlon MS, a patient-outcome comparison, or a basis for ranking brands.
Clinical · retrospective comparison · Less crepitus in one historical-control study
Femoral Implant Design Modification Decreases the Incidence of Patellar Crepitus in Total Knee Arthroplasty
Martin JR, Jennings JM, Watters TS, Levy DL, McNabb DC, Dennis DA.
J Arthroplasty · 2017 Apr
PubMed ↗ · Published article ↗ATTUNE PS vs PFC Sigma PS · 728 ATTUNE / 1,165 PFC Sigma participants · minimum 1 year
Crepitus at 2 years was 0.83% with ATTUNE and 9.4% with PFC Sigma (P < .001). Score and motion differences were not clinically meaningful.
Historical controls cannot isolate trochlear geometry from other changes. Crepitus is not the same endpoint as anterior knee pain. This is ATTUNE PS, not ATTUNE MS.
Clinical · retrospective comparison · A second comparison found no pain advantage
Comparison Between the Attune and PFC Sigma in Total Knee Arthroplasty: No Difference in Patellar Clunk and Crepitus or Anterior Knee Pain
Bateman DK, Preston JS, Mennona S, Gui E, Kayiaros S.
Orthopedics · 2020 Nov
PubMed ↗ · Published article ↗ATTUNE vs PFC Sigma · 103 ATTUNE / 114 PFC Sigma implants · mean 3.2 years
Anterior knee pain occurred in 15.5% vs 9.7% (P = .219). The study also found no significant overall difference in clunk / crepitus.
Single-surgeon series with bearing-subtype differences. A nonsignificant result does not demonstrate equivalence. Do not pool these rates with a different study’s crepitus endpoint.
Randomized clinical comparison · A positive signal with kinematic alignment
Outcomes are Better With a Medial-Stabilized vs a Posterior-Stabilized Total Knee Implanted With Kinematic Alignment
Scott DF, Gray CG.
J Arthroplasty · 2022 Aug
PubMed ↗ · Published article ↗Medial-stabilized vs posterior-stabilized TKA · both KA · 200 randomized patients (101 MS / 99 PS) · minimum 2 years
Two-year Forgotten Joint Score was 68.3 vs 58.3 (P = .02); maximum flexion was 132° vs 124° (P < .0001), favoring MS.
Single center and specific constructs. Not every participant completed every outcome measure. The comparison does not isolate the insert or establish a class-wide advantage.
Randomized clinical comparison · Another trial found similar patient scores
A Prospective Randomized Controlled Trial Comparing Medial-Pivot versus Posterior-Stabilized Total Knee Arthroplasty
Chang JS, Kayani B, Moriarty PD, Tahmassebi JE, Haddad FS.
J Arthroplasty · 2021 May
PubMed ↗ · Published article ↗Medial-pivot vs single-radius posterior-stabilized TKA · 88 patients (43 MP / 45 PS) · 2 years
Oxford Knee Score was 42.7 vs 42.3 (P = .18). ROM, WOMAC, and Knee Society scores also showed no significant between-group differences.
Different trial, constructs and outcome instruments. No detected difference is not proof of equivalence. Do not compare the numerical size of OKS and FJS across trials.
Clinical · registry comparison · Similar ten-year survival in one registry
Long-term survivorship of a medial-pivot total knee system compared with other cemented designs in an arthroplasty registry
Bordini B, Ancarani C, Fitch DA.
J Orthop Surg Res · 2016 Apr
PubMed ↗ · Published article ↗ADVANCE Medial-Pivot vs other cemented TKA designs · 506 ADVANCE / 20,446 comparator knees · mean follow-up 6.6 years · 10-year estimate
Estimated implant survival was 96.3% vs 95.7%; the difference was not statistically significant.
Observational data; one author was affiliated with the manufacturer. Survival concerns revision, not whether the knee feels normal. This older ADVANCE device is not a current-device class benchmark.
Clinical · registry comparison · A registry counterpoint: revision risk varied
Decreased Survival of Medial Pivot Designs Compared with Cruciate-retaining Designs in TKA Without Patellar Resurfacing
Øhrn FD, Gøthesen Ø, Låstad Lygre SH, Peng Y, Lian ØB, Lewis PL, Furnes O, Röhrl SM.
Clin Orthop Relat Res · 2020 Jun
PubMed ↗ · Published article ↗Five MP brands vs common CR controls · no patellar resurfacing · 6,310 MP / 70,870 CR knees · Australia and Norway · 2005–2017
Adjusted revision hazard was higher for MP in Australia (HR 1.4; 95% CI 1.2–1.7). Norway’s estimate was uncertain (HR 1.5; CI 0.9–2.4). Results differed by brand.
No patellar resurfacing; observational confounding and variable follow-up. Includes GMK Sphere, not SpheriKA. These historical findings cannot rank current MS products.
Clinical · exact-device cohort · SpheriKA: a short-term trochlear-height cohort
Restoration of the trochlear peaks is unnecessary with a kinematic alignment-optimized femoral component as under-stuffing results in equivalent or better patient-reported outcome scores
Howell SM, Zabiba A, Sadoghi P, Nedopil AJ, Hull ML.
Knee Surg Sports Traumatol Arthrosc · 2025 Dec
PubMed ↗ · Published article ↗Trochlear peak-height subgroups within GMK SpheriKA KA TKA · 115 knees · retrospective cohort · mean 22 months (12–28)
The cohort compared peak under-stuffing greater than 2 mm with restoration within ±2 mm. Several patient scores favored under-stuffing; over-stuffing was too uncommon for analysis.
No competing-implant control or long-term survival comparison. Associations do not prescribe a resection target. Authors disclosed manufacturer consulting, royalties or research support.
Focused PubMed review: 27 September 2026. Not a systematic review. Abstract-level summaries except the laboratory study, SpheriKA cohort and registry papers, for which full text was reviewed; existing Scott and Chang source reviews were retained.
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