{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:52:08Z","timestamp":1789401128776,"version":"build-2803163510"},"reference-count":4,"publisher":"SLACK, Inc.","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2009,9]]},"abstract":"<jats:p>\n            Malalignment in total knee arthroplasty (TKA) is a major source of failure. Concern exists as to the acceptable window for overall coronal alignment in TKA. We evaluated the anatomical coronal alignment of 6070 primary TKAs using standard-length knee radiographs. The mean postoperative alignment was 4.8\u00b0 of valgus, with 1 standard deviation within the mean defining a range of 2.4\u00b0 to 7.2\u00b0 of valgus. The revision rate not related to infection for this well-aligned group was 0.5% (3\u00b0=0.47%; 4\u00b0=0.54%; 5\u00b0=0.47%; 6\u00b0=0.39%; 7\u00b0=0.62%). In comparison, the failure rate for TKAs aligned in relative varus (&lt;2.4\u00b0 of valgus) was 1.8% (\n            <jats:italic toggle=\"yes\">P<\/jats:italic>\n            =.0004) and for those in valgus (&gt;7.2\u00b0 of valgus) was 1.5% (\n            <jats:italic toggle=\"yes\">P<\/jats:italic>\n            =.0027). Kaplan-Meier survival analysis confirmed these findings. The failure rates were statistically higher for the valgus and varus groups, compared to the well-aligned group within 1 standard deviation of the mean. Moreover, varusaligned knees failed primarily by medial tibial collapse, whereas valgus-aligned knees failed because of ligamentous laxity. Restoring coronal alignment to between 2.4\u00b0 and 7.2\u00b0 of anatomical valgus is the most important surgeon-controlled factor in TKA.\n          <\/jats:p>","DOI":"10.3928\/01477447-20090728-29","type":"journal-article","created":{"date-parts":[[2009,9,15]],"date-time":"2009-09-15T16:40:13Z","timestamp":1253032813000},"page":"681-682","source":"Crossref","is-referenced-by-count":30,"title":["Malalignment: Forewarned is Forearmed"],"prefix":"10.3928","volume":"32","author":[{"given":"David","family":"Fang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merrill A.","family":"Ritter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2308","reference":[{"key":"e_1_3_1_2_2","volume-title":"Paper presented at: American Association of Hip and Knee Surgeons Seventeenth Annual Fall Meeting","author":"Parratte S","unstructured":"Parratte S, Pagnano MW, Trousdale RT, Berry DJ. The mechanical axis may be the wrong target in CAS TKA: 15-year survival of 399 modern TKA: somewhat better for so-called outliers. Paper presented at: American Association of Hip and Knee Surgeons Seventeenth Annual Fall Meeting; November 2\u20134, 2007; Dallas, Texas."},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0883-5403(88)80054-8"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000148578.22729.0e"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0429-7"}],"container-title":["Orthopedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.healio.com\/doiresolver?doi=10.3928\/01477447-20090728-29","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T18:07:03Z","timestamp":1752775623000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.healio.com\/doi\/10.3928\/01477447-20090728-29"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,9]]},"references-count":4,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2009,9]]}},"alternative-id":["10.3928\/01477447-20090728-29"],"URL":"https:\/\/doi.org\/10.3928\/01477447-20090728-29","relation":{},"ISSN":["0147-7447","1938-2367"],"issn-type":[{"value":"0147-7447","type":"print"},{"value":"1938-2367","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,9]]}}}