{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:44:25Z","timestamp":1792082665841,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Patellofemoral alignment remains important after total knee arthroplasty (TKA). Robotic\u2010assisted functional positioning may reduce the impact of approach\u2010 and implant\u2010related factors on the patellofemoral joint. This study evaluated the association between surgical approach and insert constraint with postoperative static patellar alignment following robotic\u2010assisted TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective comparative radiographic study included 320 primary nonresurfaced robotic\u2010assisted TKA performed with the MAKO system between March 2021 and December 2024. Patients were divided into four groups: mini\u2010subvastus condylar\u2010stabilised (MSV\u2010CS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009134), mini\u2010subvastus posterior\u2010stabilised (MSV\u2010PS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200963), medial parapatellar condylar\u2010stabilised (MPP\u2010CS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200975) and medial parapatellar posterior\u2010stabilised (MPP\u2010PS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948). Standardised Merchant axial radiographs at 30\u00b0 and lateral radiographs were obtained at 2 months and 1 year. Patellar tilt was the primary outcome. Secondary outcomes were qualitative patellar centreing, patellar thickness and the modified Blackburne\u2013Peel index. Two\u2010way factorial analysis assessed surgical approach, insert constraint and their interaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline characteristics and final intraoperative robotic alignment parameters were comparable across groups. MSV and CS implants were associated with statistically greater patellar tilt than MPP and PS implants, respectively, but the absolute differences were small, approximately 1\u00b0. No significant interaction was observed between surgical approach and insert constraint. Patellar height did not differ between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Robotic\u2010assisted functional positioning provided consistent static patellofemoral alignment regardless of surgical approach or insert constraint. Although statistically significant differences in patellar tilt were detected, their approximately 1\u00b0 magnitude suggests a negligible radiographic effect. Their clinical significance remains unknown because clinical outcomes and dynamic patellar tracking were not assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70933","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T09:03:54Z","timestamp":1791018234000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical approach and insert constraint are associated with small differences in patellar tilt after robotic\u2010assisted total knee arthroplasty: A retrospective comparative radiographic study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1487-5066","authenticated-orcid":false,"given":"Cl\u00e9ment","family":"Favroul","sequence":"first","affiliation":[{"name":"Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix\u2010Rousse Hospital, Hospices Civils de Lyon Lyon North University Hospital Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi Drissi","family":"Kaitouni","sequence":"additional","affiliation":[{"name":"Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix\u2010Rousse Hospital, Hospices Civils de Lyon Lyon North University Hospital Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvire","family":"Servien","sequence":"additional","affiliation":[{"name":"Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix\u2010Rousse Hospital, Hospices Civils de Lyon Lyon North University Hospital Lyon France"},{"name":"LIBM\u2010EA 7424, Interuniversity Laboratory of Biology of Mobility Claude Bernard Lyon 1 University Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Batailler","sequence":"additional","affiliation":[{"name":"Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix\u2010Rousse Hospital, Hospices Civils de Lyon Lyon North University Hospital Lyon France"},{"name":"University Lyon, Claude Bernard Lyon 1 University, IFSTTAR Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Lustig","sequence":"additional","affiliation":[{"name":"Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix\u2010Rousse Hospital, Hospices Civils de Lyon Lyon North University Hospital Lyon France"},{"name":"University Lyon, Claude Bernard Lyon 1 University, IFSTTAR Lyon 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