{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:21:18Z","timestamp":1790083278730,"version":"4.0.1"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The optimal alignment strategy in unicompartmental knee arthroplasty (UKA) is debated. Recent studies have suggested that kinematic alignment may lead to improved biomechanics and outcomes. The aim of the present study was to determine if pre-arthritic\/kinematic alignment of knees would result in sustained long-term restoration of function, without conversion to total knee arthroplasty (TKA), following non-robotically assisted, fixed-bearing medial UKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A total of 236 UKAs were performed from 2000 to 2015. Of these, a total of 150 medial UKAs met the inclusion criteria and were included in the study. There were 76 UKAs performed in female patients. The mean age was 65 \u00b1 10 years and the mean body mass index was 28.6 \u00b1 5 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Patients with \u226515\u00b0 of varus alignment preoperatively were excluded. Varus deformity was evaluated with use of the hip-knee-ankle angle (HKAA). Pre-arthritic\/kinematic alignment was estimated with use of an arithmetic HKAA (aHKA, calculated as the medial proximal tibial angle minus the lateral distal femoral angle). We defined pre-arthritic\/kinematic alignment as a postoperative HKAA within 3\u00b0 of the aHKA. The primary outcome measures were the Knee Injury and Osteoarthritis Outcome Score (KOOS) Activities of Daily Living and Sport subscales, including the percentage of patients who met the patient acceptable symptom state (PASS) for these measures. Failure was defined as conversion to TKA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean follow-up was 10 years (range, 4 to 20 years), with a mean survival time estimate of 18.3 years (95% confidence interval [CI], 17.8 to 18.8). The rate of conversion to TKA was 3% (5 of 150 UKAs). Postoperatively, 127 (85%) of 150 knees were pre-arthritic\/kinematically aligned, and 23 knees (15%) were not. Patients with compared to those without pre-arthritic\/kinematically aligned knees had significantly longer mean survival (18.6 years; 95% CI, 18.2 to 19) compared with 15.4 years; 95% CI, 13.4 to 17.5, respectively; p = 0.008) and higher KOOS Activities of Daily Living (92 compared with 74; p &lt; 0.001) and Sport subscale scores (74 compared with 36; p &lt; 0.001). A greater proportion of knees in the pre-arthritic\/kinematically aligned cohort met the PASS for the KOOS Activities of Daily Living (85%, 106 of 125 knees) and Sport subscales (109 of 125, 87%) compared with the non-pre-arthritic\/kinematically aligned cohort (28% and 57%, respectively; p &lt; 0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Pre-arthritic\/kinematically aligned knees in this non-robotically assisted fixed-bearing medial UKA cohort had superior outcomes, including the KOOS Activities of Daily Living and Sport subscales and achievement of the PASS for these measures, compared with non-pre-arthritic\/kinematically aligned at an average of 10 years after UKA. Knees that fell within 3\u00b0 of a simple aHKA measurement on a 3-foot (1-m)-long standing radiograph had greater longevity and return to activities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.21.00801","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T13:47:16Z","timestamp":1655300836000},"page":"1081-1089","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":42,"title":["Pre-Arthritic\/Kinematic Alignment in Fixed-Bearing Medial Unicompartmental Knee Arthroplasty Results in Return to Activity at Mean 10-Year Follow-up"],"prefix":"10.2106","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9098-4258","authenticated-orcid":false,"given":"Kevin D.","family":"Plancher","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Montefiore Medical Center\/Albert Einstein College of Medicine, Bronx, New York"},{"name":"Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, NY"},{"name":"Plancher Orthopaedics & Sports Medicine, New York, NY"},{"name":"Orthopaedic Foundation, Stamford, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine E.","family":"Brite","sequence":"additional","affiliation":[{"name":"Plancher Orthopaedics & Sports Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7312-5662","authenticated-orcid":false,"given":"Karen K.","family":"Briggs","sequence":"additional","affiliation":[{"name":"Orthopaedic Foundation, Stamford, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie C.","family":"Petterson","sequence":"additional","affiliation":[{"name":"Orthopaedic Foundation, Stamford, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,3,29]]},"reference":[{"issue":"6","key":"bib1-20250430","doi-asserted-by":"crossref","first-page":"472","DOI":"10.2106\/JBJS.16.01587","article-title":"Effect of Postoperative Mechanical Axis Alignment on Survival and Functional Outcomes of Modern Total Knee Arthroplasties with Cement: A Concise Follow-up at 20 Years","volume":"100","author":"Abdel","year":"2018","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s11999-011-1936-5","article-title":"The Chitranjan Ranawat award: is neutral mechanical alignment normal for all patients? 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