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Related Experiment Video

Updated: May 18, 2026

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
07:33

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty

Published on: May 5, 2023

Does a kinematically aligned total knee arthroplasty restore function without failure regardless of alignment

Stephen M Howell1, Stacey J Howell, Kyle T Kuznik

  • 1Department of Mechanical Engineering, University of California at Davis, Davis, CA, USA. sebhowell@mac.com

Clinical Orthopaedics and Related Research
|September 22, 2012
PubMed
Summary

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Cartilage thickness at the apex of femoral resections in kinematically aligned total knee arthroplasty is close to 2.5 millimeters.

Journal of experimental orthopaedics·2026
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A fixed 2 mm adjustment for worn distal femoral cartilage when the cartilage of the unworn compartment is ≥3 mm does not negatively affect outcome scores after kinematically aligned total knee arthroplasty.

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA·2026
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One third of patients have articular cartilage thickness greater than three millimeters measured from femoral resections in kinematically aligned total knee arthroplasty.

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Switching From a 6° to a 20° Valgus Prosthetic Trochlear Groove Improved the Forgotten Joint and Oxford Knee Scores After Kinematically Aligned Total Knee Arthroplasty.

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Caliper measurements of femoral resection thickness in kinematic alignment total knee arthroplasty are accurate and reproducible.

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Kinematically aligned total knee arthroplasty is as effective in severe varus deformities as in mild deformities.

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA·2025

Kinematic alignment in total knee arthroplasty (TKA) restores function and shows no increased risk of failure, even with varus tibial component alignment. Concerns about poor outcomes with this technique are unfounded.

Area of Science:

  • Orthopedic surgery
  • Biomechanics
  • Knee joint reconstruction

Background:

  • Kinematically aligned total knee arthroplasty (TKA) aims to replicate natural knee joint lines.
  • Concerns exist that varus tibial component alignment in kinematic alignment may lead to poor function or early failure.

Purpose of the Study:

  • To evaluate if function and catastrophic failure rates differ based on tibial component, knee, and limb alignment outliers in kinematically aligned TKA.
  • To investigate the safety and efficacy of kinematically aligned TKA across different alignment parameters.

Main Methods:

  • Prospective study of 198 patients (214 knees) undergoing kinematically aligned TKA with cruciate-retaining prostheses.
  • Alignment was categorized into normal range, varus outlier, or valgus outlier using long-leg scanograms.

Related Experiment Videos

Last Updated: May 18, 2026

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
07:33

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty

Published on: May 5, 2023

  • Function assessed via Oxford Knee Score and WOMAC; catastrophic failure defined by revision for loosening, wear, or instability.

    • Main Results:

    • No significant difference in Oxford Knee Score or WOMAC scores across alignment categories.
    • Zero incidence of catastrophic failure observed in all alignment groups.
    • 75% of patients exhibited varus tibial component outliers with high function and no failures.

    Conclusions:

    • Kinematically aligned TKA provides good function and a zero rate of catastrophic failure, irrespective of alignment outliers.
    • The study refutes concerns that kinematic alignment compromises function or increases failure risk.
    • Findings support kinematic alignment as a viable technique, even when tibial components are in varus alignment.