{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T20:20:56Z","timestamp":1787862056481,"version":"build-2784847793"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"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>Medial unicompartmental knee arthroplasty (UKA) provides reliable outcomes in appropriately selected patients with medial compartment knee osteoarthritis. However, the effect of proximal tibia vara on implant positioning, alignment correction and patient\u2010reported outcome measures (PROMs) is not completely defined. This study aimed to evaluate the association between proximal tibia vara, tibial component positioning, postoperative coronal alignment and clinical outcomes after medial UKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Two hundred twelve patients who underwent medial UKA between 2014 and 2020 were included. Analysed parameters included medial proximal tibial angle (MPTA), hip\u2013knee\u2013ankle angle (HKA), joint line convergence angle (JLCA) and lateral distal femoral angle (LDFA). CPAK (Coronal Plane Alignment of the Knee) type and functional knee phenotypes were calculated. Patients were stratified into a normal tibia group (MPTA\u2009\u2265\u200985\u00b0,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009118) and a tibia vara group (MPTA\u2009&lt;\u200985\u00b0,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200994). Clinical outcomes were assessed using the Oxford Knee Score (OKS), Knee Society Score (KSS clinical [KSS] and functional [KSS\u2010F] subscales) and the Forgotten Joint Score\u201012 (FJS\u201012).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Outcomes were significantly better in the normal group, with higher KSS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036), OKS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and FJS\u201012 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) scores. The majority of patients were classified as CPAK Type 1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200980), while the most frequent phenotype was Var9Var3Var3 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915). Alignment correction was smaller in the tibia vara group, with a lower mean \u0394HKA (3.0\u2009\u00b1\u20092.8\u00b0 vs. 3.7\u2009\u00b1\u20092.7\u00b0, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). In subgroup analysis, mobile\u2010bearing UKA demonstrated a significantly lower FJS\u201012 in tibia vara knees (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018), whereas fixed\u2010bearing results were comparable between groups. The presence of component overhang was associated with worse clinical outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Proximal tibial vara was associated with lower postoperative scores after medial UKA. Tibial component overhang independently impaired all clinical outcomes, underscoring the clinical relevance of tibial morphology and precise component positioning in medial UKA.<\/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.70510","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T15:00:04Z","timestamp":1782313204000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Proximal tibia vara and tibial overhang are associated with inferior outcomes after medial unicompartmental knee arthroplasty"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6651-1212","authenticated-orcid":false,"given":"Yavuz","family":"Karaman","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology Ankara Bilkent City Hospital Ankara Turkey"},{"name":"Department of Orthopedics and Traumatology U\u015fak Banaz State Hospital U\u015fak Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1289-4959","authenticated-orcid":false,"given":"Enejd","family":"Veizi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Aspetar Orthopedic and Sports Medicine Hospital Doha Qatar"},{"name":"Department of Orthopedics and Traumatology Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5174-7970","authenticated-orcid":false,"given":"\u015eahan","family":"G\u00fcven","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Ankara Bilkent City Hospital Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7214-2321","authenticated-orcid":false,"given":"\u00d6mer Faruk","family":"Nald\u00f6ven","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Kayseri City Hospital Kayseri Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4804-8823","authenticated-orcid":false,"given":"Yi\u011fit Umur","family":"C\u0131rd\u0131","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Istanbul Ata\u015fehir Ac\u0131badem Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9182-7270","authenticated-orcid":false,"given":"Ahmet","family":"F\u0131rat","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology VM Medical Park Ankara 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Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/10225536261440619"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s42836-024-00242-6"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jisako.2024.100321"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12043"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12561"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.12.043"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.70204"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2016.12.036"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05509-z"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.70295"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.18.00497"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.103B2.BJJ-2020-0959.R1"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1530\/EOR-21-0133"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.103B2.BJJ-2020-1050.R1"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jisako.2024.100334"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06707-4"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.09.024"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211044146"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2024.11.041"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.4055\/cios22178"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12779"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.09.038"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-026-09714-z"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2025.08.002"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.12.041"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jeo2.70221"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.21.01080"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12282"}],"container-title":["Knee 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