{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T14:18:43Z","timestamp":1784729923564,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/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":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Medial pivot (MP) total knee arthroplasty (TKA) aims to restore native knee kinematics due to highly conforming medial tibio\u2010femoral articulation with survival comparable to contemporary knee designs. Posterior stabilized (PS) TKAs use cam\u2010post mechanism to restore native femoral rollback. However, there is conflicting evidence regarding the reported patient satisfaction with MP TKA designs when compared to PS TKAs. The primary aim of this study is to compare the patient satisfaction between MP and PS TKA and the secondary aim is to establish potential reasons behind any differences in the outcomes noted between these two design philosophies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this IRB\u2010approved single surgeon, single centre prospective RCT, 53 patients (mean age 62 years, 42 women) with comparable bilateral end\u2010stage knee arthritis undergoing simultaneous bilateral TKA were randomized to receive MP TKA in one knee and PS TKA in the contralateral knee. At 4 years post\u2010surgery, all patients were assessed using Knee Society Score (KSS)\u2010Satisfaction and \u2010Expectation scores, and Oxford Knee Score (OKS). In addition, all the patients underwent standardized radiological and in vivo kinematic assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients were more satisfied with the MP TKA as compared to PS TKA: mean KSS\u2010Satisfaction [34.5\u2009\u00b1\u20093.05\u00a0in MP and 31.7\u2009\u00b1\u20093.16\u00a0in PS TKAs (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001)] and mean KSS\u2010Expectation scores [12.5\u2009\u00b1\u20091.39\u00a0in MP TKAs and 11.2\u2009\u00b1\u20091.41\u00a0in PS TKAs (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001)]. No significant difference was noted in any other clinical outcomes. The in vivo kinematics of MP TKAs was significantly better than those of PS TKAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MP TKAs provide superior patient satisfaction and patient expectations as compared to PS TKA. This may be related to better replication of natural knee kinematics with MP TKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>I.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-06343-4","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T13:03:04Z","timestamp":1604581384000},"page":"3633-3640","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Superior patient satisfaction in medial pivot as compared to posterior stabilized total knee arthroplasty: a prospective randomized study"],"prefix":"10.1002","volume":"29","author":[{"given":"Sahil","family":"Batra","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics All India Institute of Medical Sciences (AIIMS) 110029 New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5971-003X","authenticated-orcid":false,"given":"Rajesh","family":"Malhotra","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics All India Institute of Medical Sciences (AIIMS) 110029 New Delhi India"},{"name":"<!--<label>5<\/label>--> Department of Orthopedics All India Institute of Medical Sciences (AIIMS) Room No 139, Teaching Block, Ansari Nagar 110029 New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Kumar","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedics All India Institute of Medical Sciences (AIIMS) 110029 New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deep Narayan","family":"Srivastava","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Radiodiagnosis All India Institute of Medical Sciences (AIIMS) 110029 New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Backstein","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Division of Orthopaedics, Granovsky Gluskin Chair in Complex Hip &amp; Knee Reconstruction, Sinai Health System University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemant","family":"Pandit","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Chapel Allerton Hospital University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,5]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2015.09.038"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0268\u20100033(95)92044\u2010M"},{"key":"e_1_2_8_4_2","unstructured":"BlandM(2011)Sample size for clinical trials.https:\/\/www\u2010users.york.ac.uk\/~mb55\/msc\/trials\/sampsz.htm. 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May 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 November 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"SB, RM, VK and DN have no conflict of interest. DB reports personal fees from Microport Orthopedics and Chairs Editorial Board Office at Journal of Arthroplasty, Clinical Orthopaedics and Related Research and held shares in Intelijoint Surgical outside the submitted work. HP reports personal fees from Zimmer Biomet, Medacta, Depuy Synthes and Meril Life, and grants from Zimmer Biomet, Depuy Synthes and GSK outside the submitted work. HP is a National Institute for Health Research (NIHR) Senior Investigator. The views expressed in this article are those of the author(s) and not necessarily those of the NIHR, or the Department of Health and Social Care.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study did not receive any funding of any nature.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"All procedures performed in studies involving human participants were in accordance with the Ethical Standards of the Institutional and\/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}