Indelli Pier F, Violante Bruno, Skowronek Pawel, Ostojić Marko, Bouguennec Nicolas, Aloisi Giuseppe, Schaller Christian, Longo Giuseppe U
European Society of Sports Traumatology, Knee Surgery Arthroscopy (ESSKA)-European Knee Associates (EKA) Board Luxembourg Luxembourg.
European Society of Sports Traumatology, Knee Surgery Arthroscopy (ESSKA) Basic Science Committee Luxembourg Luxembourg.
J Exp Orthop. 2025 Jul 18;12(3):e70358. doi: 10.1002/jeo2.70358. eCollection 2025 Jul.
The recent introduction of personalized alignment strategies in total knee arthroplasty (TKA) has transformed adult reconstruction. Proponents advocate for these techniques due to their kinematic benefits compared to traditional methods. Current literature supports combining medial-pivot designs with kinematic alignment (KA) surgery. This review summarizes the application of gait analysis in KA medial-pivot TKA and recommends gait parameters related to patient satisfaction.
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). One hundred twenty-one articles from the three search engines underwent a preliminary title/abstract and full-text screening. The final screening resulted in 23 systematic reviews (SR), meta-analyses (M-A) and narrative reviews (NR) as core articles of the current umbrella review.
Out of the original 121 SR/M-A/NR articles, 23 (19%) were ultimately evaluated based on the reported results. Twelve articles fell into the first category (gait analysis following TKA as the main topic), five articles were designated for the second category (knee implant design), only one article was classified in the third category (kinematic alignment) and five articles were assigned to the fourth category (a combination of all main topics).
The literature investigating the relationship between kinematic and spatiotemporal data and clinical outcomes following KA medial pivot TKA is limited. Few studies included in the current review showed that remote measurements using wearable sensors are more informative than patients' reported outcome measurements (PROMs) regarding a patient's daily level of activities and, ultimately, gait. The current review demonstrated that combining KA and MP designs can ensure a knee kinematic closer to normal than combining MA and more traditional implant designs.
Level I.
全膝关节置换术（TKA）中近期引入的个性化对线策略改变了成人关节重建领域。与传统方法相比，这些技术具有运动学优势，因此支持者主张采用这些技术。目前的文献支持将内侧旋转平台设计与运动学对线（KA）手术相结合。本综述总结了步态分析在KA内侧旋转平台TKA中的应用，并推荐了与患者满意度相关的步态参数。
本综述遵循系统评价和Meta分析扩展版的首选报告项目（PRISMA-ScR）。对来自三个搜索引擎的121篇文章进行了初步的标题/摘要和全文筛选。最终筛选出23篇系统评价（SR）、Meta分析（M-A）和叙述性综述（NR）作为当前综合综述的核心文章。
在最初的121篇SR/M-A/NR文章中，最终根据报告结果评估了23篇（19%）。12篇文章属于第一类（以TKA后的步态分析为主要主题），5篇文章归为第二类（膝关节植入物设计），只有1篇文章属于第三类（运动学对线），5篇文章被归入第四类（所有主要主题的组合）。
研究KA内侧旋转平台TKA后运动学和时空数据与临床结果之间关系的文献有限。当前综述中纳入的少数研究表明，对于患者的日常活动水平以及最终的步态，使用可穿戴传感器进行的远程测量比患者报告的结局测量（PROMs）提供了更多信息。当前综述表明，与MA和更传统的植入物设计相结合相比，KA和MP设计相结合可以确保膝关节运动学更接近正常。
I级。
