2026 COA: Posterior-Stabilized vs Medial Pivot Knee Designs in Total Knee Arthroplasty .

18 randomized controlled trials involving 1446 patients and 1503 total knee arthroplasties (TKA) were included in this systematic review and meta-analysis comparing medial pivot and posterior-stabilized knee designs. Pooled outcomes of interest included complications, Knee Society Score (KSS) 1989 and 2011 subscores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), and Forgotten Joint Score (FJS). The analysis demonstrated largely comparable outcomes between implant designs across all measured domains, with the exception of a modest improvement in the KSS Function 1989 subscore favouring the medial pivot design. These findings suggest that both implant designs provide similar clinical outcomes following TKA, with only limited evidence supporting a functional advantage of the medial pivot design.