{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T16:39:23Z","timestamp":1793032763648,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"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":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>A goal of kinematic alignment (KA) total knee arthroplasty (TKA) is to align the femoral component to restore the distal and posterior femoral joint lines to prearthritic. To restore the joint line on the worn distal condyle, the resection thickness is adjusted by 2\u2009mm for cartilage loss based on the reported average cartilage thickness on magnetic resonance imaging. It remains unclear whether a 2\u2009mm fixed adjustment is ideal for all patients, especially those with thicker cartilage. This study examined whether a 2\u2009mm fixed adjustment in patients with cartilage thickness \u22653.0\u2009mm negatively affects the Forgotten Joint Score (FJS), Oxford Knee Score (OKS) and Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR) compared to those with cartilage thickness &lt;3.0\u2009mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 96 KA TKAs with preoperative varus (85%) and valgus (15%) deformities, cartilage thickness was measured using a calibrated photographic method on a medial\u2010lateral bisection of the unworn distal femoral condyle. At 1 year after surgery, equivalence was assessed in FJS, OKS and KOOS JR between patients with cartilage thickness \u22653.0\u2009mm and those with &lt;3.0\u2009mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall average cartilage thickness was 2.8\u2009\u00b1\u20090.6\u2009mm (range, 1.6\u20135.0\u2009mm), with 41% having a cartilage thickness \u22653.0\u2009mm. The mean FJS was 78 versus 74 points for those with &lt;3.0 and \u22653.0\u2009mm cartilage, and these results were statistically equivalent (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0150). Similarly, mean OKS scores of 42 versus 41\u00a0points (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0071), and KOOS JR scores of 80 versus 81 points, were statistically equivalent (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although a large percentage of patients had unworn cartilage thickness \u22653 mm, outcome scores were comparble to patients with thickness &lt;3 mm. Hence, surgeons can use a\u00a02\u2009mm fixed adjustment for cartilage loss, even when the cartilage thickness exceeds 3\u2009mm, with a range up to 5.0\u2009mm, without\u00a0negatively affecting the FJS, OKS or KOOS JR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70320","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T12:49:00Z","timestamp":1771246140000},"page":"4023-4031","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A fixed 2\u2009mm adjustment for worn distal femoral cartilage when the cartilage of the unworn compartment is \u22653\u2009mm does not negatively affect outcome scores after kinematically aligned total knee arthroplasty"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3655-158X","authenticated-orcid":false,"given":"Alexander Johannes","family":"Nedopil","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, K\u00f6nig\u2010Ludwig\u2010Haus University of W\u00fcrzburg W\u00fcrzburg Germany"},{"name":"Institute for Orthopaedic Surgery and Research, College of Medicine California Northstate University Elk Grove California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deeksha","family":"Mamidi","sequence":"additional","affiliation":[{"name":"College of Medicine California Northstate University Elk Grove California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8184-0324","authenticated-orcid":false,"given":"Stephen Miller","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of California at Davis 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":"Institute for Orthopaedic Surgery and Research, College of Medicine California Northstate University Elk Grove California USA"},{"name":"Department of Biomedical Engineering University of California at Davis Davis California USA"},{"name":"Department of Mechanical Engineering Univerisity of California at Davis Davis California USA"},{"name":"Department of Orthopaedic Surgery University of California at Davis Medical Center Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5256"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12725"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2776-5"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.103B5.BJJ-2020-0396.R1"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-023-05834-6"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-023-00671-3"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198911000-00003"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jeo2.70155"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-06939-y"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12712"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-37131-8_2"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12671"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2020.0024"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2015.05.049"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3080-8"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.4068613"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12071152"},{"key":"e_1_2_11_19_1","volume-title":"Knee","author":"Nedopil 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