{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:53:21Z","timestamp":1790916801978,"version":"4.1.0"},"reference-count":53,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedics & Traumatology: Surgery & Research"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.otsr.2026.104904","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:56:14Z","timestamp":1790265374000},"page":"104904","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["The orientation of the patellar resection plane influences postoperative tilt and occurrence of radiolucent lines in cementless asymmetric patellar resurfacing in TKA"],"prefix":"10.1016","author":[{"given":"Marco","family":"Pungitore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Meissner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudy","family":"Sangaletti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo V.","family":"Vasiliadis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Theus-Steinmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilman","family":"Calliess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Leggieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Innocenti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.otsr.2026.104904_bib0005","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1186\/s13018-025-05892-z","article-title":"Functional outcome and cost effectiveness of patellar resurfacing and non-resurfacing in total knee arthroplasty: systematic review and meta-analysis","volume":"20","author":"Usman","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"10.1016\/j.otsr.2026.104904_bib0010","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s13018-024-04546-w","article-title":"Different modalities of patellar management in primary total knee arthroplasty: a Bayesian network meta-analysis of randomized controlled trials","volume":"19","author":"Liu","year":"2024","journal-title":"J Orthop Surg Res"},{"key":"10.1016\/j.otsr.2026.104904_bib0015","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1302\/0301-620X.105B6.BJJ-2022-0970.R2","article-title":"Patellar resurfacing versus retention in cruciate-retaining and posterior-stabilized total knee arthroplasty","volume":"105-B","author":"Simpson","year":"2023","journal-title":"Bone Joint J"},{"key":"10.1016\/j.otsr.2026.104904_bib0020","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.knee.2023.01.021","article-title":"Patellar resurfacing was not associated with a clinically significant advantage when a modern patellar friendly total knee arthroplasty is employed: a systematic review and meta-analysis","volume":"41","author":"Simpson","year":"2023","journal-title":"Knee"},{"key":"10.1016\/j.otsr.2026.104904_bib0025","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1111\/os.13392","article-title":"Patellar resurfacing in primary total knee arthroplasty: a meta-analysis and trial sequential analysis of 50 randomized controlled trials","volume":"15","author":"Tang","year":"2023","journal-title":"Orthop Surg"},{"key":"10.1016\/j.otsr.2026.104904_bib0030","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1186\/s12891-022-05877-7","article-title":"Clinical effectiveness of patellar resurfacing, no resurfacing and selective resurfacing in primary total knee replacement: systematic review and meta-analysis of interventional and observational evidence","volume":"23","author":"Grela","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.otsr.2026.104904_bib0035","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s13018-020-02185-5","article-title":"Patellar resurfacing versus nonresurfacing in total knee arthroplasty: an updated meta-analysis of randomized controlled trials","volume":"16","author":"Chen","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"10.1016\/j.otsr.2026.104904_bib0040","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.otsr.2019.01.025","article-title":"Have the frequency of and reasons for revision total knee arthroplasty changed since 2000? Comparison of two cohorts from the same hospital: 255 cases (2013-2016) and 68 cases (1991-1998)","volume":"105","author":"Pietrzak","year":"2019","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2026.104904_bib0045","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1302\/0301-620X.99B5.BJJ-2016-0617.R3","article-title":"Contemporary failure aetiologies of the primary, posterior-stabilised total knee arthroplasty","volume":"99-B","author":"Abdel","year":"2017","journal-title":"Bone Joint J"},{"key":"10.1016\/j.otsr.2026.104904_bib0050","doi-asserted-by":"crossref","first-page":"451","DOI":"10.2106\/JBJS.21.00356","article-title":"Factors affecting the risk of aseptic patellar complications in primary TKA performed with cemented all-polyethylene patellar resurfacing","volume":"104","author":"Limberg","year":"2022","journal-title":"JBJS"},{"key":"10.1016\/j.otsr.2026.104904_bib0055","article-title":"How to optimize patellar tracking in knee arthroplasty?","volume":"109","author":"Lustig","year":"2023","journal-title":"Orthopaedics & Traumatology: Surgery & Research"},{"key":"10.1016\/j.otsr.2026.104904_bib0060","doi-asserted-by":"crossref","first-page":"2110","DOI":"10.1016\/j.arth.2015.05.038","article-title":"Resection technique does affect resection symmetry and thickness of the patella during total knee arthroplasty: a prospective randomized trial","volume":"30","author":"Camp","year":"2015","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.otsr.2026.104904_bib0065","article-title":"Preoperative patellofemoral malalignment worsened the outcome of patients after total knee arthroplasty","author":"Huang","year":"2025","journal-title":"J Knee Surg"},{"key":"10.1016\/j.otsr.2026.104904_bib0070","doi-asserted-by":"crossref","first-page":"2642","DOI":"10.1016\/j.arthro.2024.08.009","article-title":"Anatomic risk factors for lateral patellar instability","volume":"40","author":"Only","year":"2024","journal-title":"Arthroscopy"},{"key":"10.1016\/j.otsr.2026.104904_bib0075","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s12306-022-00764-9","article-title":"Management of patella maltracking after total knee arthroplasty: a systematic review","volume":"107","author":"Ferri","year":"2023","journal-title":"Musculoskelet Surg"},{"key":"10.1016\/j.otsr.2026.104904_bib0080","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1177\/230949900901700322","article-title":"Review article: Patellar instability after total knee arthroplasty","volume":"17","author":"Motsis","year":"2009","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"10.1016\/j.otsr.2026.104904_bib0085","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s00264-013-2081-4","article-title":"Anterior knee pain after total knee arthroplasty: a narrative review","volume":"38","author":"Petersen","year":"2014","journal-title":"Int Orthop"},{"key":"10.1016\/j.otsr.2026.104904_bib0090","first-page":"10","article-title":"Patellar malalignment treatment in total knee arthroplasty","volume":"1","author":"Gasparini","year":"2013","journal-title":"Joints"},{"key":"10.1016\/j.otsr.2026.104904_bib0095","doi-asserted-by":"crossref","first-page":"2925","DOI":"10.1016\/j.arth.2019.07.033","article-title":"Preoperative radiological parameters predicting the need for lateral retinacular release in total knee arthroplasty","volume":"34","author":"Rajkumar","year":"2019","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.otsr.2026.104904_bib0100","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1007\/s00167-009-0832-y","article-title":"Radiographic features predictive of patellar maltracking during total knee arthroplasty","volume":"17","author":"Chia","year":"2009","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.otsr.2026.104904_bib0105","article-title":"Anatomic risk factors for patellofemoral joint instability: an infographic as a visual learning tool","volume":"16","author":"Vasiliadis","year":"2024","journal-title":"Cureus"},{"key":"10.1016\/j.otsr.2026.104904_bib0110","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/00003086-199011000-00020","article-title":"Patellar resurfacing in total knee arthroplasty","author":"Rand","year":"1990","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.otsr.2026.104904_bib0115","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1007\/s00264-015-2715-9","article-title":"Effects of patellofemoral overstuffing on knee flexion and patellar kinematics following total knee arthroplasty: a cadaveric study","volume":"39","author":"Bracey","year":"2015","journal-title":"Int Orthop"},{"key":"10.1016\/j.otsr.2026.104904_bib0120","doi-asserted-by":"crossref","first-page":"163","DOI":"10.5312\/wjo.v5.i3.163","article-title":"Anterior knee pain after a total knee arthroplasty: What can cause this pain?","volume":"5","author":"Breugem","year":"2014","journal-title":"World J Orthop"},{"key":"10.1016\/j.otsr.2026.104904_bib0125","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1111\/os.70016","article-title":"Comparison of patellar tracking following kinematic alignment versus mechanical alignment total knee arthroplasty via the mini-subvastus approach","volume":"17","author":"Sun","year":"2025","journal-title":"Orthop Surg"},{"key":"10.1016\/j.otsr.2026.104904_bib0130","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.knee.2021.11.013","article-title":"Patellar tilt does not affect patient reported outcomes after modern total knee arthroplasty","volume":"34","author":"Naveen","year":"2022","journal-title":"Knee"},{"key":"10.1016\/j.otsr.2026.104904_bib0135","article-title":"Does patellar resurfacing matter in robotic-assisted total knee arthroplasty with functional alignment principles? Knee Surgery, Sports Traumatology","author":"Diquattro","year":"2025","journal-title":"Arthroscopy"},{"key":"10.1016\/j.otsr.2026.104904_bib0140","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s00402-018-3073-z","article-title":"Suboptimal patellofemoral alignment is associated with poor clinical outcome scores after primary total knee arthroplasty","volume":"139","author":"Narkbunnam","year":"2019","journal-title":"Arch Orthop Trauma Surg"},{"key":"10.1016\/j.otsr.2026.104904_bib0145","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/00003086-198811000-00009","article-title":"Patellar prosthesis positioning in total knee arthroplasty. A roentgenographic study","author":"Gomes","year":"1988","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.otsr.2026.104904_bib0150","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.2106\/00004623-200708000-00020","article-title":"Patellofemoral evaluation after total knee arthroplasty: validation of a new weight-bearing axial radiographic view","volume":"89","author":"Baldini","year":"2007","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.otsr.2026.104904_bib0155","first-page":"228","article-title":"Asymmetric patella resurfacing in total knee arthroplasty","volume":"13","author":"Pagnano","year":"2000","journal-title":"Am J Knee Surg"},{"key":"10.1016\/j.otsr.2026.104904_bib0160","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.arth.2003.12.066","article-title":"Accuracy of haptic assessment of patellar symmetry in total knee arthroplasty","volume":"19","author":"DeOrio","year":"2004","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.otsr.2026.104904_bib0165","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.4103\/sja.SJA_543_18","article-title":"The STROBE guidelines","volume":"13","author":"Cuschieri","year":"2019","journal-title":"Saudi J Anaesth"},{"key":"10.1016\/j.otsr.2026.104904_bib0170","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1302\/0301-620X.75B5.8376449","article-title":"Radiographic analysis of patellar tilt","volume":"75","author":"Grelsamer","year":"1993","journal-title":"J Bone Joint Surg Br"},{"key":"10.1016\/j.otsr.2026.104904_bib0175","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1007\/s00167-020-05984-9","article-title":"Patellar component size effects patellar tilt in total knee arthroplasty with patellar resurfacing","volume":"29","author":"Joseph","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.otsr.2026.104904_bib0180","doi-asserted-by":"crossref","first-page":"2656","DOI":"10.1007\/s00167-015-3930-z","article-title":"Patella position is not a determinant for anterior knee pain 10 years after balanced gap total knee arthroplasty","volume":"24","author":"van Houten","year":"2016","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.otsr.2026.104904_bib0185","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s12306-015-0347-2","article-title":"Evaluation of anterior knee pain in a PS total knee arthroplasty: the role of patella-friendly femoral component and patellar size","volume":"99","author":"Atzori","year":"2015","journal-title":"Musculoskelet Surg"},{"key":"10.1016\/j.otsr.2026.104904_bib0190","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.arth.2016.08.032","article-title":"Do changes in patellofemoral joint offset lead to adverse outcomes in total knee arthroplasty with patellar resurfacing? A radiographic review","volume":"32","author":"Matz","year":"2017","journal-title":"The Journal of Arthroplasty"},{"key":"10.1016\/j.otsr.2026.104904_bib0195","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1007\/s00167-020-06081-7","article-title":"Kinematic aligned femoral rotation leads to greater patella tilt but similar clinical outcomes when compared to traditional femoral component rotation in total knee arthroplasty. A propensity score matched study","volume":"29","author":"Koh","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.otsr.2026.104904_bib0200","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1007\/s00167-012-2245-6","article-title":"Patellar tilt and thickness do not influence postoperative flexion in a high-flex design total knee arthroplasty","volume":"21","author":"Dhollander","year":"2013","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.otsr.2026.104904_bib0205","doi-asserted-by":"crossref","first-page":"3163","DOI":"10.1002\/ksa.12234","article-title":"Individualised compared to off-the-shelf total knee arthroplasty results in lower and less variable patellar tilt","volume":"32","author":"Beel","year":"2024","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.otsr.2026.104904_bib0210","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1016\/j.arth.2023.03.056","article-title":"Anatomic patellar design has no clinical superiority over dome patellar design in total knee arthroplasty: a randomized clinical trial","volume":"38","author":"Kim","year":"2023","journal-title":"The Journal of Arthroplasty"},{"key":"10.1016\/j.otsr.2026.104904_bib0215","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1186\/s13018-025-05858-1","article-title":"Anatomic patella design versus medialized dome design in the modern posterior stabilized (ATTUNE) total knee arthroplasty: a systematic review and meta-analysis","volume":"20","author":"Hajiaghajani","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"10.1016\/j.otsr.2026.104904_bib0220","doi-asserted-by":"crossref","DOI":"10.1177\/2309499021996068","article-title":"Difference in patient-reported outcomes of various patellar component designs in total knee arthroplasty: a randomized clinical study","volume":"29","author":"Mochizuki","year":"2021","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"10.1016\/j.otsr.2026.104904_bib0225","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13226894","article-title":"The influence of kinematic alignment on patellofemoral joint biomechanics in total knee arthroplasty","volume":"13","author":"Simon","year":"2024","journal-title":"Journal of Clinical Medicine"},{"key":"10.1016\/j.otsr.2026.104904_bib0230","first-page":"10","article-title":"Redefining the concept of patellofemoral stuffing in total knee arthroplasty","author":"Shatrov","year":"2025","journal-title":"Journal of ISAKOS"},{"key":"10.1016\/j.otsr.2026.104904_bib0235","doi-asserted-by":"crossref","first-page":"3252","DOI":"10.1002\/ksa.12335","article-title":"Kinematical alignment better restores native patellar tracking pattern than mechanical alignment","volume":"32","author":"Kim","year":"2024","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.otsr.2026.104904_bib0240","doi-asserted-by":"crossref","first-page":"352","DOI":"10.4055\/cios20168","article-title":"The influence of femoral internal rotation on patellar tracking in total knee arthroplasty using gap technique","volume":"13","author":"Ko","year":"2021","journal-title":"Clin Orthop Surg"},{"key":"10.1016\/j.otsr.2026.104904_bib0245","doi-asserted-by":"crossref","DOI":"10.3390\/jpm12101724","article-title":"The Trochlear Groove of a femoral component designed for kinematic alignment is lateral to the quadriceps line of force and better laterally covers the anterior femoral resection than a mechanical alignment design","volume":"12","author":"Sappey-Marinier","year":"2022","journal-title":"J Pers Med"},{"key":"10.1016\/j.otsr.2026.104904_bib0250","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1007\/s00167-018-5284-9","article-title":"Kinematic alignment in total knee arthroplasty leads to a better restoration of patellar kinematics compared to mechanic alignment","volume":"27","author":"Keshmiri","year":"2019","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.otsr.2026.104904_bib0255","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1177\/0954411917727564","article-title":"Effect of rotational prosthetic alignment variation on tibiofemoral contact pressure distribution and joint kinematics in total knee replacement","volume":"231","author":"Xie","year":"2017","journal-title":"Proc Inst Mech Eng H"},{"key":"10.1016\/j.otsr.2026.104904_bib0260","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1007\/s00264-018-4264-5","article-title":"Clinical and radiologic outcomes of two patellar resection techniques during total knee arthroplasty: a prospective randomized controlled study","volume":"43","author":"Yuan","year":"2019","journal-title":"International Orthopaedics (SICOT)"},{"key":"10.1016\/j.otsr.2026.104904_bib0265","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1055\/a-2530-7953","article-title":"Effect of resurfaced patellar thickness on outcomes after total knee arthroplasty","volume":"38","author":"Dandamudi","year":"2025","journal-title":"J Knee Surg"}],"container-title":["Orthopaedics & Traumatology: Surgery & Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877056826003257?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877056826003257?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:57:22Z","timestamp":1790913442000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1877056826003257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":53,"alternative-id":["S1877056826003257"],"URL":"https:\/\/doi.org\/10.1016\/j.otsr.2026.104904","relation":{},"ISSN":["1877-0568"],"issn-type":[{"value":"1877-0568","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The orientation of the patellar resection plane influences postoperative tilt and occurrence of radiolucent lines in cementless asymmetric patellar resurfacing in TKA","name":"articletitle","label":"Article Title"},{"value":"Orthopaedics & Traumatology: Surgery & Research","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.otsr.2026.104904","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Masson SAS.","name":"copyright","label":"Copyright"}],"article-number":"104904"}}