{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T09:15:47Z","timestamp":1769937347139,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,3,31]],"date-time":"2016-03-31T00:00:00Z","timestamp":1459382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,3,31]],"date-time":"2016-03-31T00:00:00Z","timestamp":1459382400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aims to analyse the influence on total knee arthroplasty (TKA) clinical outcomes of biomechanical intra\u2010operative computer\u2010assisted surgery\u2010measured parameters, together with radiographic and demographical data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2007 and 2009, 227 computer\u2010assisted surgery (CAS) primary TKAs were performed in 219 consecutive patients. Information about gender, age and body mass index (BMI) was collected for each patient. Before knee replacement, all patients underwent a complete radiographic examination and passive flexion\u2013extension range of motion was recorded. All TKAs were implanted using an image\u2010free knee navigation system. Patients included in the study were evaluated at 3, 6 and 12\u00a0months of follow\u2010up and then yearly. At each follow\u2010up, subjects were asked to answer the validated Italian version of the Knee Injury and Osteoarthritis Outcome Score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and eighty patients (187\u00a0knees) had data available for analysis. Complications were reported in 13 patients (7.0 %). Intra\u2010operative CAS\u2010measured parameters, together with age, BMI, gender, pre\u2010 and post\u2010operative radiographic alignment, did not influence TKA clinical results at a mean 2 years of follow\u2010up. On the other hand, higher post\u2010operative flexion arc of movement was suggestive of better clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TKA clinical outcome is influenced by post\u2010operative knee flexion, other than neutral mechanical limb alignment. Therefore, it is recommended to prefer TKA designs that allow high flexion and to encourage early physical rehabilitation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-016-4094-1","type":"journal-article","created":{"date-parts":[[2016,3,31]],"date-time":"2016-03-31T07:06:46Z","timestamp":1459408006000},"page":"3339-3345","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Clinical outcome is not affected by total knee arthroplasty alignment"],"prefix":"10.1002","volume":"24","author":[{"given":"Raffaele","family":"Mugnai","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology University of Modena and Reggio Emilia Via del Pozzo 71 41124 Modena 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