Level I RCT extending a prior 2-year study to 5-year follow-up, comparing kinematic alignment (patient-specific cutting blocks) versus mechanical alignment (computer navigation) in 99 primary TKAs for osteoarthritis. Asks whether kinematic alignment's theoretical advantage — recreating pre-arthritic anatomy — produces better patient-reported outcomes, survivorship, or radiographic results at mid-term follow-up.
When a patient or colleague asks whether kinematic alignment produces better outcomes than mechanical alignment, this is the highest-quality mid-term evidence: no functional advantage at 5 years, but a meaningful proportion of kinematic tibial components land in >5° varus — a biomechanically unfavorable position whose long-term survivorship consequences remain unproven.
Until independent 10-year+ data exist, kinematic alignment should not be adopted as routine practice outside a research context.
Level I RCT extending a prior 2-year study to 5-year follow-up, comparing kinematic alignment (patient-specific cutting blocks) versus mechanical alignment (computer navigation) in 99 primary TKAs for osteoarthritis. Asks whether kinematic alignment's theoretical advantage — recreating pre-arthritic anatomy — produces better patient-reported outcomes, survivorship, or radiographic results at mid-term follow-up.
When a patient or colleague asks whether kinematic alignment produces better outcomes than mechanical alignment, this is the highest-quality mid-term evidence: no functional advantage at 5 years, but a meaningful proportion of kinematic tibial components land in >5° varus — a biomechanically unfavorable position whose long-term survivorship consequences remain unproven.
Until independent 10-year+ data exist, kinematic alignment should not be adopted as routine practice outside a research context.