Alignment philosophy in TKA has more impact on trochlear anatomy restoration as the LDFA decreases.

Purpose: Most implants currently used in total knee arthroplasty (TKA) were designed based on mechanical alignment (MA) principles. Modern alignment philosophies alter the orientation of these classic designs by following each individual's knee phenotype, which may have important implications on trochlear restoration. This study aims to compare the influence of different alignment strategies on trochlear anatomy recreation within predefined lateral distal femoral angle (LDFA) groups.

Increased prevalence of lateral trochlear groove wear among valgus alignment subtypes by coronal knee alignment classification: A retrospective single-center study.

Introduction: The Coronal Plane Alignment of The Knee (CPAK) classification aims to restore the constitutional knee alignment, although it neglects the patellofemoral joint. Therefore, this study aims to examine the correlation between trochlear groove wear (TGW) patterns and CPAK classifications.

Methods: Our institutional database was queried to include unilateral primary total knee arthroplasties (TKA) between 2021 and 2025.

Difference in laxity between single- and multi-radius total knee arthroplasty implants is greatest in extension when gap-balancing at 10° flexion.

Background: This study quantified the relative impact of single-vs multi-radius femoral implant designs on coronal ligament laxity throughout flexion when gap planning at 10 and 90° flexion. These changes in laxity were also compared to those resulting from a change in the implant alignment technique.

Methods: One hundred fifty-four consecutive robotic-assisted TKAs performed with a robotic ligament tensioning device, a cruciate-retaining single-radius (SR) femoral implant and an inverse kinematic alignment (iKA) technique were reviewed.

Imageless robotic total knee arthroplasty determines similar coronal plane alignment of the knee (CPAK) parameters to long leg radiographs.

Background: The coronal plane alignment of the knee (CPAK) classification was first developed using long leg radiographs (LLR) and has since been reported using image-based and imageless robotic total knee arthroplasty (TKA) systems. However, the correspondence between imageless robotics and LLR-derived CPAK parameters has yet to be investigated. This study therefore examined the differences in CPAK parameters determined with LLR and imageless robotic navigation using either generic or optimized cartilage wear assumptions.

Personalized alignment techniques better restore the native trochlear groove compared to systematic alignment techniques in total knee arthroplasty.

Purpose: The relationship between constitutional coronal alignment and implant positioning on trochlear groove restoration in total knee arthroplasty (TKA) is poorly understood. This study aimed to determine whether the choice of alignment philosophy significantly affects the restoration of the trochlea groove.

Methods: Sixty-one imageless robotic TKAs performed by a single orthopaedic surgeon were retrospectively reviewed.

Patient reported outcome measures correlate with step-count in total hip arthroplasty.

Background: Passive smartphone-based apps are becoming more common for measuring patient progress after total hip arthroplasty (THA). Optimum activity levels during early THA recovery have not been well documented.

Objectives: Correlations between step-count and patient reported outcome measures (PROMs) during early recovery were explored.

Restricted Inverse Kinematic Alignment Better Restores the Native Joint Line Orientation While Achieving Similar Balance, Laxity, and Arithmetic Hip-Knee-Ankle Angle to Gap Balancing Total Knee Arthroplasty.

Background: Both restricted inverse kinematic alignment (iKA) and gap balancing aim for a balanced total knee arthroplasty by adjusting femoral component position based on ligamentous gaps. However, iKA targets a native tibial joint line vs resecting perpendicular to the mechanical axis. This study compares how these 2 techniques impact the balance and laxity throughout flexion and joint line obliquity (JLO), arithmetic hip-knee-ankle angle (aHKA), and the coronal plane alignment of the knee (CPAK).

Restricted kinematic alignment achieves similar relative lateral laxity and greater joint line obliquity compared to gap balancing TKA.

Purpose: The purpose of this study was to compare ligament balance and laxity profiles achieved throughout flexion in restricted kinematic alignment (rKA) and gap balancing (GB). rKA and GB both aim to improve soft tissue balance and reduce ligament releases in total knee arthroplasty (TKA).

Methods: One surgeon performed 68 rKA, another performed 73 GB TKAs using the same CR implant and robotic system.

The effects of graft size and insertion site location during anterior cruciate ligament reconstruction on intercondylar notch impingement.

Background: Intercondylar notch impingement is detrimental to the anterior cruciate ligament (ACL). Notchplasty is a preventative remodeling procedure performed on the intercondylar notch during ACL reconstruction (ACLR). This study investigates how ACL graft geometry and both tibial and femoral insertion site location may affect ACL-intercondylar notch interactions post ACLR.

The effects of knee joint kinematics on anterior cruciate ligament injury and articular cartilage damage.

This study determined which knee joint motions lead to anterior cruciate ligament (ACL) rupture with the knee at 25° of flexion. The knee was subjected to internal and external rotations, as well as varus and valgus motions. A failure locus representing the relationship between these motions and ACL rupture was established using finite element simulations.