Clinical outcomes of restricted kinematic alignment versus mechanical alignment in total knee arthroplasty: a meta-analysis of randomized controlled trials

Abstract Background Restricted Kinematic Alignment (rKA) is a well-established technique for total knee arthroplasty (TKA) that aims to approximate natural knee motion within defined safety boundaries. This meta-analysis aims to evaluate the clinical efficacy of rKA compared to mechanical alignment...

Full description

Saved in:
Bibliographic Details
Main Authors: Xiao-peng Gao, Miao Zhang, Zi-yi Zhang, Xiao-tong Li
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12891-025-08868-6
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849423375233974272
author Xiao-peng Gao
Miao Zhang
Zi-yi Zhang
Xiao-tong Li
author_facet Xiao-peng Gao
Miao Zhang
Zi-yi Zhang
Xiao-tong Li
author_sort Xiao-peng Gao
collection DOAJ
description Abstract Background Restricted Kinematic Alignment (rKA) is a well-established technique for total knee arthroplasty (TKA) that aims to approximate natural knee motion within defined safety boundaries. This meta-analysis aims to evaluate the clinical efficacy of rKA compared to mechanical alignment (MA) in TKA. Method A comprehensive search was conducted in the PubMed, Embase, Web of Science, and Cochrane Library databases for randomized controlled trials (RCTs) published from the inception of these databases until December 6, 2024. RCTs assessing the clinical efficacy of rKA and MA in TKA were included. A total of six RCTs were analyzed. Results A total of six RCTs involving 444 patients were included in the analysis. The meta-analysis revealed that the Knee Society Score (KSS) and McMaster Universities Osteoarthritis Index (WOMAC) scores were significantly higher in the rKA group compared to the MA group. However, no significant differences were found between the rKA and MA groups in terms of the Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score (KOOS), Forgotten Joint Score (FJS), hip-knee-ankle angle (HKA), and lateral distal femoral angle (LDFA). Additionally, the postoperative revision rate in the rKA group was not significantly different from that in the MA group. Conclusion This study suggests that rKA provides better functional outcomes in TKA compared to MA, particularly in terms of WOMAC score and KSS. Clinical trial number Not applicable.
format Article
id doaj-art-c305366caa47481f8508cc4d73610185
institution Kabale University
issn 1471-2474
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series BMC Musculoskeletal Disorders
spelling doaj-art-c305366caa47481f8508cc4d736101852025-08-20T03:30:36ZengBMCBMC Musculoskeletal Disorders1471-24742025-07-0126111010.1186/s12891-025-08868-6Clinical outcomes of restricted kinematic alignment versus mechanical alignment in total knee arthroplasty: a meta-analysis of randomized controlled trialsXiao-peng Gao0Miao Zhang1Zi-yi Zhang2Xiao-tong Li3Department of Orthopaedics, WeiFang People’s Hospital, Shandong Second Medical UniversityDepartment of Orthopaedics, WeiFang People’s Hospital, Shandong Second Medical UniversityDepartment of Orthopaedics, WeiFang People’s Hospital, Shandong Second Medical UniversityDepartment of Respiratory and Critical Care Medicine, WeiFang People’s Hospital, Shandong Second Medical UniversityAbstract Background Restricted Kinematic Alignment (rKA) is a well-established technique for total knee arthroplasty (TKA) that aims to approximate natural knee motion within defined safety boundaries. This meta-analysis aims to evaluate the clinical efficacy of rKA compared to mechanical alignment (MA) in TKA. Method A comprehensive search was conducted in the PubMed, Embase, Web of Science, and Cochrane Library databases for randomized controlled trials (RCTs) published from the inception of these databases until December 6, 2024. RCTs assessing the clinical efficacy of rKA and MA in TKA were included. A total of six RCTs were analyzed. Results A total of six RCTs involving 444 patients were included in the analysis. The meta-analysis revealed that the Knee Society Score (KSS) and McMaster Universities Osteoarthritis Index (WOMAC) scores were significantly higher in the rKA group compared to the MA group. However, no significant differences were found between the rKA and MA groups in terms of the Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score (KOOS), Forgotten Joint Score (FJS), hip-knee-ankle angle (HKA), and lateral distal femoral angle (LDFA). Additionally, the postoperative revision rate in the rKA group was not significantly different from that in the MA group. Conclusion This study suggests that rKA provides better functional outcomes in TKA compared to MA, particularly in terms of WOMAC score and KSS. Clinical trial number Not applicable.https://doi.org/10.1186/s12891-025-08868-6Restricted kinematic alignmentMechanical alignmentTotal knee arthroplasty
spellingShingle Xiao-peng Gao
Miao Zhang
Zi-yi Zhang
Xiao-tong Li
Clinical outcomes of restricted kinematic alignment versus mechanical alignment in total knee arthroplasty: a meta-analysis of randomized controlled trials
BMC Musculoskeletal Disorders
Restricted kinematic alignment
Mechanical alignment
Total knee arthroplasty
title Clinical outcomes of restricted kinematic alignment versus mechanical alignment in total knee arthroplasty: a meta-analysis of randomized controlled trials
title_full Clinical outcomes of restricted kinematic alignment versus mechanical alignment in total knee arthroplasty: a meta-analysis of randomized controlled trials
title_fullStr Clinical outcomes of restricted kinematic alignment versus mechanical alignment in total knee arthroplasty: a meta-analysis of randomized controlled trials
title_full_unstemmed Clinical outcomes of restricted kinematic alignment versus mechanical alignment in total knee arthroplasty: a meta-analysis of randomized controlled trials
title_short Clinical outcomes of restricted kinematic alignment versus mechanical alignment in total knee arthroplasty: a meta-analysis of randomized controlled trials
title_sort clinical outcomes of restricted kinematic alignment versus mechanical alignment in total knee arthroplasty a meta analysis of randomized controlled trials
topic Restricted kinematic alignment
Mechanical alignment
Total knee arthroplasty
url https://doi.org/10.1186/s12891-025-08868-6
work_keys_str_mv AT xiaopenggao clinicaloutcomesofrestrictedkinematicalignmentversusmechanicalalignmentintotalkneearthroplastyametaanalysisofrandomizedcontrolledtrials
AT miaozhang clinicaloutcomesofrestrictedkinematicalignmentversusmechanicalalignmentintotalkneearthroplastyametaanalysisofrandomizedcontrolledtrials
AT ziyizhang clinicaloutcomesofrestrictedkinematicalignmentversusmechanicalalignmentintotalkneearthroplastyametaanalysisofrandomizedcontrolledtrials
AT xiaotongli clinicaloutcomesofrestrictedkinematicalignmentversusmechanicalalignmentintotalkneearthroplastyametaanalysisofrandomizedcontrolledtrials