{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T02:34:26Z","timestamp":1773887666475,"version":"3.50.1"},"reference-count":27,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,4]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the relation between component rotation in total knee replacement and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective, observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Deventer hospital, Deventer, The Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>498 adults aged 18 years and older undergoing total knee replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Participants underwent Persona posterior stabilised total knee replacement. Femoral and tibial component rotation was measured using low-dose CT scans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was the change in Oxford Knee Score from baseline to 1 year, analysed in relation to femoral, tibial and combined component rotation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Binary logistic regression analysis showed no statistically significant association between femoral component rotation (OR=1.04, 95%\u2009CI 0.89 to 1.21, p=0.644), tibial component rotation (OR=0.99, 95%\u2009CI 0.94 to 1.03, p=0.467), or combined rotation (OR=0.99, 95%\u2009CI 0.95 to 1.03, p=0.552), and achievement of the minimal clinically important difference of 5 points for the 48-point Oxford Knee Score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This prospective study of 498\u2009patients undergoing total knee replacement did not provide evidence of a relation between the rotational alignment of total knee arthroplasty components and clinical outcomes. These findings do not support routine evaluation of rotational alignment as a basis for revision surgery in patients with persistent pain in the absence of mechanical problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>Dutch Trial registry ID: 23362.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-110439","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T21:55:31Z","timestamp":1773870931000},"page":"e110439","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Patient-reported outcomes and component rotation in total knee replacement: a prospective, observational study in 498 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