{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:14:35Z","timestamp":1791285275234,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Assessing the risk of tibial baseplate loosening in patients after unrestricted kinematically aligned (unKA) total knee arthroplasty (TKA) using a medially conforming insert is important because baseplates generally are aligned in varus which has been linked to an increased incidence of aseptic loosening following mechanically aligned TKA. Two limits that indicate long\u2010term stability in patients are a change in maximum total point motion between 1 and 2 years (\u0394MTPM)\u2009&lt;\u20090.2\u2009mm and anterior tilt at 2 years\u2009&lt;\u20090.8\u00b0. The purposes were to determine: (1) the number of patients with \u0394MTPM\u2009&gt;\u20090.2\u2009mm, (2) the number of patients with anterior tilt\u2009&gt;\u20090.8\u00b0\u00a0and (3) whether increased varus baseplate and limb alignment were associated with increased migration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010five patients underwent cemented, caliper\u2010verified, unKA TKA using a medially conforming tibial insert with posterior cruciate ligament (PCL) retention. Biplanar radiographs acquired on the day of surgery and at 1.5, 3, 6, 12\u00a0and 24 months were processed with model\u2010based radiostereometric analysis (RSA) software to determine migration and the number of patients with migration above the two stability limits. Medial proximal tibial angle (MPTA), hip\u2010knee\u2010ankle angle (HKAA)\u00a0and posterior slope angle (PSA) were analyzed for an association with migration in six degrees of freedom and in MTPM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010two of 35 patients were available for analysis at 2 years. One patient exhibited \u0394MTPM\u2009&gt;\u20090.2\u2009mm. The same patient exhibited anterior tilt\u2009&gt;\u20090.8\u00b0. Varus rotation (<jats:italic>p<\/jats:italic>\u2009=\u20090.048, <jats:italic>r<\/jats:italic>\u2009\u2264\u20090.34) and medial translation (<jats:italic>p<\/jats:italic>\u2009=\u20090.0273, <jats:italic>r<\/jats:italic>\u2009\u2264\u20090.29) increased with increased varus baseplate alignment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results indicate low risk of long\u2010term baseplate loosening in patients. Although varus rotation and medial translation increased with increased varus baseplate alignment, the magnitudes of the migrations were minimal and did not increase \u0394MTPM and anterior tilt.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level II, therapeutic prospective cohort study.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12089","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T07:13:15Z","timestamp":1709104395000},"page":"693-703","source":"Crossref","is-referenced-by-count":16,"title":["Risk of tibial baseplate loosening is low in patients following unrestricted kinematic alignment total knee arthroplasty using a cruciate\u2010retaining medial conforming insert: A study using radiostereometric analysis\u00a0at 2 years"],"prefix":"10.1002","volume":"32","author":[{"given":"Abigail E.","family":"Niesen","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering University of California Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranav A.","family":"Tirumalai","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of California Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of California Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8305-4589","authenticated-orcid":false,"given":"Maury L.","family":"Hull","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of California Davis California USA"},{"name":"Department of Mechanical Engineering University of California Davis California USA"},{"name":"Department of Orthopaedic Surgery University of California Davis Medical Center Sacramento California 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