{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T07:48:14Z","timestamp":1784620094039,"version":"3.55.0"},"reference-count":41,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T00:00:00Z","timestamp":1722816000000},"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>This study aimed to compare in vivo kinematics during weight\u2010bearing daily activities and determine the relationship with clinical outcomes in patients undergoing total knee arthroplasty (TKA) with a medial\u2010pivot (MP, Evolution\u2122) versus a posterior\u2010stabilized (PS, Persona\u00ae) design under constant conditions of intraoperative soft tissue balance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty patients undergoing MP or PS\u2010TKA under similar conditions of soft tissue balance were enrolled in this prospective randomized controlled trial. Outcome measures included clinical knee society scores (KSS) and knee injury and osteoarthritis outcome scores (KOOS). A kinematic assessment was conducted while the participants performed lunge and step\u2010up activities under fluoroscopic guidance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen patients in each arm completed 1\u2010year follow\u2010up and were included in the analysis. All patients experienced pain relief and satisfactory knee function postoperatively. In kinematics, in the MP arm, the medial femoral condyle remained consistent, whereas the lateral femoral condyle gradually shifted posteriorly with increasing knee flexion. Conversely, in the PS arm, paradoxical anterior movement of the medial femoral condyle accompanied the lateral pivot motion. During lunge and step\u2010up activities, a medial\u2010pivot motion was observed in 83% and 72% of knees in the MP arm, respectively, compared with 22% and 11% in the PS arm. Despite these differences in kinematics, there were no statistically significant differences in the KSS and KOOS between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Under weight\u2010bearing conditions during flexion, knees that underwent Evolution\u2122 MP\u2010TKA did not show superior clinical results compared to Persona\u00ae PS\u2010TKA, despite exhibiting in vivo kinematics closely resembling the normal in vivo pattern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level I, therapeutic studies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12399","type":"journal-article","created":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T05:09:22Z","timestamp":1722834562000},"page":"3289-3298","source":"Crossref","is-referenced-by-count":6,"title":["Medial\u2010pivot design does not provide superior clinical results compared to posterior\u2010stabilized total knee arthroplasty despite kinematic differences during step\u2010up and lunge activities: A prospective randomized controlled trial under medial tight soft tissue balance"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4144-6063","authenticated-orcid":false,"given":"Eiichi","family":"Nakamura","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Kumamoto Kaiseikai Hospital Kumamoto Japan"},{"name":"Department of Orthopedic Surgery Kumamoto University Hospital Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobukazu","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Kumamoto University Hospital Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Kumamoto University Hospital Kumamoto 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