Functional alignment restores native kinematics more consistently than mechanical axis alignment in total knee arthroplasty.

この研究はインパクトが大きい可能性があると判断されました。 OEのAIによるハイインパクト指標は、論文が掲載されたジャーナルと論文自体の科学的内容の両方からのシグナルを統合することで、論文の影響力を推定します。 最先端の自然言語処理を用いて開発されたOEハイインパクトモデルは、ジャーナルのインパクトファクターのみよりも、研究の将来の引用実績をより正確に予測します。 これにより、臨床的に意義のある研究をより早く認識することができ、読者は将来の診療を形成する可能性が最も高い論文に焦点を当てることができます。

研究概要

Sixty patients with knee osteoarthritis were randomized to receive either functional alignment (FA) (n=29) or adjusted mechanical alignment (aMA) (n=31) using a robotically assisted cruciate-retaining total knee arthroplasty. The primary outcome was the intraoperative kinematic pattern (medial pivot, symmetrical rollback, or lateral pivot) assessed with a pressure sensor after definitive implantation. Secondary outcomes included knee balance, range of motion, and multiple patient-reported outcome measures (PROMs) at 12 months. FA produced a medial pivot in 58.6%, symmetrical rollback in 37.9%, and lateral pivot in 3.4% of cases; aMA produced a medial pivot in 19.4%, symmetrical rollback in 45.2%, and lateral pivot in 35.5%. Medial pivot patterns were associated with higher Forgotten Joint Scores, EQ-5D VAS, and lower rest pain, whereas lateral pivot patterns were linked to lower Kujala scores. Overall, FA more consistently replicated native medial pivot kinematics, which correlated with better clinical outcomes compared to lateral pivot patterns. These findings suggest alignment strategy influences intraoperative kinematics and may impact functional recovery.