Knee Surgery Sports Traumatology Arthroscopy · IF 3.3 · September 29, 2026 · LoE III
Improved function and patient satisfaction with fewer residual symptoms following kinematically versus mechanically aligned total knee arthroplasty: A retrospective study from FP‐UCBM Knee Study Group
Stefano Campi, Giancarlo Giurazza, Edoardo Franceschetti, Michael Tobias Hirschmann, Andrea Tanzilli, Michele Paciotti, Biagio Zampogna, Matteo Pepe, Pietro Gregori, Umile Giuseppe Longo, Rocco Papalia — Università Campus Bio-Medico
This single-centre retrospective study compared 315 patients who had total knee replacement using unrestricted kinematic alignment (KA), which recreates each patient's native joint lines, with 307 patients who had conventional mechanical alignment (MA), all using the same medial pivot implant. At 1 year, overall satisfaction was higher with KA (94.0% vs 81.1%; adjusted odds ratio 3.91, 95% CI 2.25 to 6.79). The KA group also reported less pain, less popping, fewer car and chair difficulties, and higher Forgotten Joint Scores (91.7 vs 82.7), while stair climbing, stiffness and swelling did not differ.
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersUp to one in five patients is dissatisfied after TKA, and alignment philosophy (kinematic versus mechanical) is a high-yield, actively debated topic in arthroplasty.
Conclusion strengthConfirms prior evidence
The effect is reported only as a ratio, with no control-arm event rate, so how much absolute difference it represents cannot be judged.
Presenting this at rounds? Start here
- ?If kinematic alignment improves satisfaction, which knee phenotypes or patient groups would you prioritise for it, and when would you still choose mechanical alignment?
- ?How would you counsel a patient about residual symptoms such as pain, popping, or difficulty with stairs after TKA, regardless of the alignment technique used?