{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:21:20Z","timestamp":1786123280866,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The primary aim was to analyze unrestricted kinematic alignment (unKA) total knee arthroplasty (TKA) and determine the frequency of medial deviation of the prosthetic trochlear angle (PTA) of the femoral component relative to the quadriceps vector (QV) that terminates at the anterior inferior iliac spine (AIIS), and whether patients with medial deviation had a worse Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) relative to those with lateral deviation. The secondary aim was to determine the frequency of medial deviation for mechanical alignment (MA) TKA simulations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From a database of a single surgeon, the study extracted de\u2010identified data on 147 patients with a CT scanogram showing the pelvis and AIIS, a limb with an unKA TKA, and a native (i.e., healthy) opposite limb. On the scanogram, an examiner, blinded to the PROMs, measured the PTA\u2010QV angle on the unKA TKA and on the opposite limb simulated MA TKA by drawing the PTA at 6\u00b0 valgus relative to the femoral mechanical axis and measuring the PTA\u2010QV angle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Medial deviation of the PTA occurred in 86% of patients with unKA TKA, and the 126 with medial deviation had a 17\/1 point worse median FJS\/OKS than the 21 with lateral deviation at a mean follow\u2010up of 47\u2009\u00b1\u20098\u00a0months, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0053). In addition, 21%, 17%, and 8% of MA TKA had medial deviation after radiographic simulation using reported surgical errors for manual, patient\u2010specific, and robotic instrumentation, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In most patients with unKA TKA and a smaller proportion with MA TKA, a PTA of 6\u00b0 valgus was medial to the QV, which, by excluding the patient\u2019s Q\u2010angle, might alter patellofemoral kinematics like an incorrectly oriented trochleoplasty. The 17\u2010point worse FJS in the patients with an unKA TKA and medial deviation of the PTA suggests the surgical target should be to orient the PTA lateral to the QV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00167-023-07598-3","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T05:02:22Z","timestamp":1696395742000},"page":"5438-5445","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Better forgotten joint scores when the angle of the prosthetic trochlea is lateral to the quadriceps vector in kinematically aligned total knee arthroplasty"],"prefix":"10.1002","volume":"31","author":[{"given":"Stephen M.","family":"Howell","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering University of California 95616 Davis CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0902-5760","authenticated-orcid":false,"given":"Elliot","family":"Sappey\u2010Marinier","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California 94143 San Francisco CA USA"},{"name":"Department of Orthopaedic Surgery Ramsay Sant\u00e9 H\u00f4pital Priv\u00e9 Jean Mermoz Centre Orthop\u00e9dique Santy 69008 Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail E.","family":"Niesen","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of California 95616 Davis CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Nedopil","sequence":"additional","affiliation":[{"name":"Orthop\u00e4dische Klinik K\u00f6nig\u2010Ludwig\u2010Haus Lehrstuhl f\u00fcr Orthop\u00e4die der Universit\u00e4t W\u00fcrzburg 97074 W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maury L.","family":"Hull","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of California 95616 Davis CA USA"},{"name":"Department of Orthopedic Surgery University of California Davis Medical Center 95817 Sacramento CA USA"},{"name":"Department of Mechanical Engineering University of California 95616 Davis CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010199304000\u201000032"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2005.04.027"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5256"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.103B5.BJJ\u20102020\u20100396.R1"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010014\u20103163\u20106"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.103B6.BJJ\u20102020\u20102003.R1"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200300004\u201000010"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010199610000\u201000004"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010021\u201006725\u20102"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005507\u20101"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005508\u20100"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010021\u201006473\u20103"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010022\u201006939\u2010y"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100040\u20101716413"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20105220\u2010z"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2016.02.044"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010008\u20100639\u20103"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12071152"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010011\u20102222\u20102"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm13050778"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2018.05.010"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2017.10.009"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010023\u201007405\u2010z"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010022\u201007251\u20105"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12101724"},{"key":"e_1_2_10_27_1","unstructured":"TakashimaY NakanoN IshidaK KamenagaT TsubosakaM KurodaY HayashiS KurodaR MatsumotoTEffects of femoral component design on the deepest point position of the trochlear grove in kinematically aligned total knee arthroplasty: a comparison of four prothesis designs.J Knee Surg202210.1055\/s\u20100042\u2010175650236150661"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010012\u20102741\u20105"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.018318"}],"container-title":["Knee Surgery, Sports Traumatology, 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July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 September 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 October 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures were performed 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. This study received institutional review board approval (IRB 1450380-1), and all participants gave valid consent to participate.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}