{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T14:24:24Z","timestamp":1761402264604,"version":"build-2065373602"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Joint dynamics following Total Knee Arthroplasty (TKA) may influence patient\u2010reported outcome. Simulations allow many knee alignment approaches to a single patient to be considered prior to surgery. The simulated kinematics can be matched to patient\u2010reported outcome to predict kinematic patterns most likely to give the best outcome. This study aims to validate one such previously developed algorithm based on a simulated deep knee bend (the Dynamic Knee Score, DKS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>1074 TKA patients with pre\u2010 and post\u2010operative Computerised Tomography (CT) scans and 12\u2010month post\u2010operative Knee Injury and Osteoarthritis Outcomes (KOOS) Scores were identified from the 360\u00a0Med Care Joint Registry. Landmarking and registration of implant position was performed on all CT scans, and each of the achieved TKAs was computationally simulated and received a predictive outcome score from the DKS. In addition, a set of potential alternative surgical plans which might have been followed were simulated. Comparison of patient\u2010reported issues and DKS score was evaluated in a counter\u2010factual study design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patient\u2010reported impairment with the knee catching and squatting was shown to be 30% lower (<jats:italic>p<\/jats:italic>\u2009=\u20090.005) and 22% lower (<jats:italic>p<\/jats:italic>\u2009=\u20090.026) in patients where the best possible DKS result was the one surgically achieved. Similar findings were found relating attainment of the best tibial slope and posterior femoral resection DKS plans to patient\u2010reported difficulty straightening the knee (40% less likely, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and descending stairs (35% less likely, <jats:italic>p<\/jats:italic>\u2009=\u20090.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The DKS has been shown to correlate with presence of patient\u2010reported impairments post\u2010TKA and the resultant algorithm can be applied in a pre\u2010operative planning setting. Outcome optimization in the future may come from patient\u2010specific selection of an alignment strategy and simulations may be a technological enabler of this trend.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence.<\/jats:title><jats:p>III (Retrospective Cohort Study).\n<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07225-7","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T17:09:04Z","timestamp":1669741744000},"page":"1098-1105","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Patient\u2010reported impairment following TKA is reduced when a computationally simulated predicted ideal alignment is achieved"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0063-0435","authenticated-orcid":false,"given":"Joshua","family":"Twiggs","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> 360MedCare Suite 3, Building 1\/20 Bridge St, Pymble 2073 Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brad","family":"Miles","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> 360MedCare Suite 3, Building 1\/20 Bridge St, Pymble 2073 Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Parker","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Sydney Orthopaedic Research Institute 2067 Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Liu","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Gold Coast Centre for Bone and Joint Surgery 4221 Gold Coast Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Shimmin","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Melbourne Orthopaedic Group 3181 Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett","family":"Fritsch","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Sydney Orthopaedic Research Institute 2067 Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Roe","sequence":"additional","affiliation":[{"name":"<!--<label>5<\/label>--> North Sydney Orthopaedic and Sports Medicine Centre The Mater Hospital 2060 Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Bar\u00e9","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Melbourne Orthopaedic Group 3181 Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Solomon","sequence":"additional","affiliation":[{"name":"<!--<label>6<\/label>--> Sydney Orthopaedic Specialists 2031 Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Dickison","sequence":"additional","affiliation":[{"name":"<!--<label>7<\/label>--> Peninsula Orthopaedics 2099 Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"McMahon","sequence":"additional","affiliation":[{"name":"<!--<label>8<\/label>--> Malabar Orthopaedic Clinic 3181 Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Boyle","sequence":"additional","affiliation":[{"name":"<!--<label>9<\/label>--> Boyle Orthopaedics 2042 Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Len","family":"Walter","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> 360MedCare Suite 3, Building 1\/20 Bridge St, Pymble 2073 Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,29]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1350\u20104533(98)00010\u20101"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2012.09.011"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.84B1.0840050"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102011\u2010000435"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20105174\u20101"},{"key":"e_1_2_10_7_2","unstructured":"BraileanuP Bou\u2010Sa\u00efdB SimionI StoicaG(2019)Method of extracting hip joint bones from C.T.images in order to perform static F.E.A. study. 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Brad Miles; Royalties from Corin; Paid consultant to 360 Med Care; Stock with 360 Med Care. David Dickison: Paid presentations for Stryker, Paid consultant to Stryker, Unpaid consultant to and stock options in 360 MedCare. David Liu: Royalties from Zimmer Biomet; Paid speaker for Zimmer Biomet, Depuy; Paid consultant to Zimmer Biomet, Depuy; Unpaid consultant to and stock options in 360 Med Care. David Parker: Unpaid consultant to and stock options in 360 Medcare, Stock options in Trium, Personalized Surgery, research support from Arthrex, Smith & Nephew. Jonathan Bar\u00e9: Royalties from Corin, Paid consultant to Corin, MatOrtho, Unpaid consultant to and stock options in 360 Med Care, stock options in Corin, research support from MatOrtho. Justin Roe: Paid presentations for Smith, Depuy, Unpaid consultant to and stock options in 360 Med Care. Joshua Twiggs: paid employee of 360 Med Care. Len Walter: Unpaid consultant to and stock options in 360 Medcare. Michael Solomon: Royalties from Medacta and Corin, Paid presentations with Corin, Unpaid consultant to and stock options in 360 Medcare. Richard Boyle: Paid presentations for Life Healthcare, Paid consultant to Lima, Stryker, Unpaid consultant to and stock options in 360 Medcare, Stock options in Ossis. Stephen McMahon: Royalties from Corin, Paid consultant to Corin, Unpaid consultant to Smith and Nephew, Unpaid consultant to and stock options in 360 Med Care, research support from Smith and Nephew and Corin.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethics was approved by Bellberry Human Research and Ethics Committee (Protocol 2012-03-710).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}