{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T13:00:41Z","timestamp":1775739641817,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"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."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Robotic\u2010assisted (RA) surgery allows for higher accuracy in total knee arthroplasty (TKA) and for better standardization of alignment concepts. It was hypothesized that the more personalized component placement in functional robotic\u2010assisted total knee arthroplasty (RA\u2010TKA) would show an impact on patella mobility and clinical outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective study was performed on 80 patients who received TKA (Triathlon; Stryker). In 51 patients, the prosthesis was implanted using MAKO robotic assistance (RA\u2010TKA), while 29 patients underwent conventional implantation (conventional total knee arthroplasty [C\u2010TKA]). Patella mobility was compared pre\u2010 and postoperatively after three months. Medial and lateral translation was measured in extension by using a patellostabilometer (PSM), which measures medio\u2010lateral patella mobility under a force of 10\u2009N. Clinical assessment was based on Oxford Knee Score (OKS), Knee Society Score (KSS), Kujala and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The medio\u2010lateral patella mobility was 31\u2009\u00b1\u20099\u2009mm before and 34\u2009\u00b1\u20097\u2009mm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) after surgery. There was no significant difference in mediolateral patella mobility between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.282). Patella mobility increased by 3\u2009mm in both groups after surgery. The medial and lateral shift ranged between 14 and 18\u2009mm. All clinical scores (OKS, KSS, Kujala and WOMAC score) improved significantly from before to after surgery (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.001) without difference between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RA\u2010TKA did not result in changes in patella mobility when compared to conventional implantation. Other factors, such as general joint laxity or implant design and component placement, may have a more significant impact on patella mobility and clinical outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II, prospective designed study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70380","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:51:57Z","timestamp":1775735517000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["No difference in patella mobility between conventional mechanically aligned and robotic\u2010assisted functionally aligned total knee arthroplasty"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1064-1671","authenticated-orcid":false,"given":"Krzysztof","family":"Lachowski","sequence":"first","affiliation":[{"name":"Center of Orthopaedics and Traumatology University Hospital Brandenburg\/Havel, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karim Mustapha","family":"Naja","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology University Hospital Brandenburg\/Havel, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Prill","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology University Hospital Brandenburg\/Havel, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Medical School Theodor Fontane Potsdam Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Niemeier","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Hospital Reinbeck St. Adolf\u2010Stift GmbH Reinbeck Germany"},{"name":"Department of Orthopaedics University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikhail","family":"Salzmann","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology University Hospital Brandenburg\/Havel, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1833-7608","authenticated-orcid":false,"given":"Roland","family":"Becker","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology University Hospital Brandenburg\/Havel, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Medical School Theodor Fontane Potsdam Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1097\/JSA.0b013e318053eb74","article-title":"Current concepts on anatomy and biomechanics of patellar stability","volume":"15","author":"Amis AA","year":"2007","journal-title":"Sports Med Arthrosc"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1016\/j.jbiomech.2005.04.027","article-title":"The difference in trochlear orientation between the natural knee and current prosthetic knee designs; towards a truly physiological prosthetic groove orientation","volume":"39","author":"Barink M","year":"2006","journal-title":"J Biomech"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s00167-014-2860-5","article-title":"The importance of the third knee compartment on outcome following total knee arthroplasty","volume":"22","author":"Becker R","year":"2014","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.clinbiomech.2010.08.009","article-title":"Extensor malalignment arising from femoral component malrotation in knee arthroplasty: effect of rotating\u2010bearing","volume":"26","author":"Colwell CW","year":"2011","journal-title":"Clin Biomech"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1136\/bjsports-2016-096384","article-title":"2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient\u2010reported outcome measures","volume":"50","author":"Crossley KM","year":"2016","journal-title":"Br J Sports Med"},{"key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.3390\/diagnostics12051082","article-title":"Patellar tracking in total knee arthroplasty\u2014influence on clinical and functional outcome","volume":"12","author":"Dahlmann S","year":"2022","journal-title":"Diagnostics"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1186\/s13018-021-02681-2","article-title":"Association of patellofemoral morphology and alignment with the radiographic severity of patellofemoral osteoarthritis","volume":"16","author":"Dai Y","year":"2021","journal-title":"J Orthop Surg"},{"key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1002\/ksa.12088","article-title":"High three\u2010dimensional accuracy of component placement and lower limb alignment using a robotic arm\u2010assisted system and gap\u2010balancing instrument in total knee arthroplasty","volume":"32","author":"Diquattro E","year":"2024","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"12","key":"e_1_2_12_10_1","first-page":"4234","article-title":"Patellofemoral alignment safe zones in robotic\u2010assisted TKA do not affect outcomes but do influence patellar resurfacing rates","volume":"33","author":"Diquattro E","year":"2025","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1186\/s12891-017-1529-x","article-title":"Differences between native and prosthetic knees in terms of cross\u2010sectional morphology of the femoral trochlea: a study based on three\u2010dimensional models and virtual total knee arthroplasty","volume":"18","author":"Du Z","year":"2017","journal-title":"BMC Musculoskelet 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S","year":"2025","journal-title":"J Arthroplasty"},{"key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1007\/s00167-019-05587-z","article-title":"Healthy knees have a highly variable patellofemoral alignment: a systematic review","volume":"28","author":"Hochreiter B","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.3390\/bioengineering11010062","article-title":"Differences in trochlear morphology of a new femoral component designed for kinematic alignment from a mechanical alignment design","volume":"11","author":"Hull ML","year":"2024","journal-title":"Bioengineering"},{"key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1007\/s11999-009-1156-4","article-title":"The geometry of the trochlear groove","volume":"468","author":"Iranpour F","year":"2010","journal-title":"Clin Orthop Relat 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Traumatol Arthrosc"},{"key":"e_1_2_12_27_1","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1007\/s00264-022-05570-3","article-title":"Alignment philosophy influences trochlea recreation in total knee arthroplasty: a comparative study using image\u2011based robotic technology","volume":"47","author":"Shatrov J","year":"2023","journal-title":"Int Orthop"},{"key":"e_1_2_12_28_1","doi-asserted-by":"crossref","first-page":"795","DOI":"10.5312\/wjo.v6.i10.795","article-title":"Anterior knee pain following primary total knee arthroplasty","volume":"6","author":"Shervin D","year":"2015","journal-title":"World J Orthop"},{"key":"e_1_2_12_29_1","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1007\/s00167-013-2534-8","article-title":"No difference in patellar tracking between symmetrical and asymmetrical femoral component designs in TKA","volume":"22","author":"Stoddard JE","year":"2014","journal-title":"Knee Surg Sports Traumatol 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