Kinematic vs Mechanical Alignment in TKA Shows No Meaningful Benefit .
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Kinematic Alignment Does Not Result in Clinically Important Improvements After TKA Compared With Mechanical Alignment: A Meta-analysis of Randomized Trials.
Clin Orthop Relat Res . 2025 Jun 1;483(6):1020-1030.Twelve randomized controlled trials including 1033 patients undergoing primary TKA for knee osteoarthritis were included in this systematic review and meta-analysis comparing kinematic alignment versus mechanical alignment. Pooled outcomes of interest included functional scores (OKS/WOMAC), Forgotten Joint Score (FJS), EQ-5D, VAS, and ROM in flexion and extension. Across nine pooled studies, functional score differences favored kinematic alignment statistically but did not exceed the MCID. No significant or clinically important differences were observed for FJS, EQ-5D VAS, or extension ROM, and flexion ROM differences (3°) did not meet MCID thresholds. The findings suggest no clinically important advantage of kinematic alignment over mechanical alignment in TKA outcomes.
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