{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:07:49Z","timestamp":1790957269081,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to compare postoperative patellar tilt at 4 months follow\u2010up in a consecutive series of randomised patients that received individualised or off\u2010the\u2010shelf (OTS) primary total knee arthroplasty (TKA). The hypothesis was that patellar tilt would be lower and less variable in patients who received individualised TKA compared to patients who received OTS TKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A consecutive series of 385 patients randomised (1:1) to receive either OTS TKA or individualised TKA were analysed. Pre\u2010 and postoperative radiographs at 4 months were obtained of weight\u2010bearing long leg, anterior\u2013posterior and lateral knee views\u00a0and a skyline view at 30\u00b0 of flexion. Postoperative patellar tilt was measured between the anterior femoral line and patellar resection surface (<jats:italic>\u03b2<\/jats:italic>) and the anterior femoral line and mediolateral patellar axis (<jats:italic>\u03c3<\/jats:italic>). Postoperative patellar tilt (absolute value) was compared between the individualised and OTS TKA groups based on preoperative phenotypes of their femoral mechanical angle, tibial mechanical angle and hip\u2013knee\u2013ankle angle. Variability in postoperative patellar tilt was compared using the 95% confidence intervals (CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Comparisons of baseline patient characteristics revealed no difference between the individualised and OTS TKA groups. Comparison of absolute postoperative patellar tilt revealed significant differences between individualised and OTS TKA (|<jats:italic>\u03b2<\/jats:italic>|, 1.0\u00b0\u2009\u00b1\u20091.0\u00b0 and 2.5\u00b0\u2009\u00b1\u20092.2\u00b0,\u00a0respectively,\u00a0<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; |<jats:italic>\u03c3<\/jats:italic>|, 1.7\u00b0\u2009\u00b1\u20091.6\u00b0 and 2.8\u00b0\u2009\u00b1\u20092.3\u00b0,\u00a0respectively,\u00a0<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The 95% CI\u00a0of postoperative patellar tilt (|<jats:italic>\u03b2<\/jats:italic>|) was narrower in patients that received individualised compared to OTS TKA (0.0\u00b0 to 3.8\u00b0 and 0.1\u00b0 to 8.3\u00b0, respectively), irrespective of their preoperative phenotype.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients who underwent individualised TKA had lower and less variable postoperative patellar tilt than those with OTS TKA, irrespective of preoperative phenotype. Individualised TKA allows the decoupling of the tibiofemoral and patellofemoral joints, replicating anatomical trochlear orientation and improving patellar tilt, which could facilitate better clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p>This study constitutes a part of a larger registered randomised controlled trial comparing patient satisfaction following OTS versus individualised TKA (NCT04460989).<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level II.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12234","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T04:29:15Z","timestamp":1718166555000},"page":"3163-3173","source":"Crossref","is-referenced-by-count":14,"title":["Individualised compared to off\u2010the\u2010shelf total knee arthroplasty results in lower and less variable patellar tilt"],"prefix":"10.1002","volume":"32","author":[{"given":"Wouter","family":"Beel","sequence":"first","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliot","family":"Sappey\u2010Marinier","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshan","family":"Latifi","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery Department Aalborg University Hospital  Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"ReSurg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarik","family":"A\u00eft\u2010Si\u2010Selmi","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel P.","family":"Bonnin","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). 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