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Knee Surgery Sports Traumatology Arthroscopy
Article . 2025 . Peer-reviewed
License: CC BY
Data sources: Crossref
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PubMed Central
Article . 2025
License: CC BY
Data sources: PubMed Central
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Kinematic alignment doesn't tell the whole story: It's time for kinetic alignment

Authors: Umile Giuseppe Longo; Giovanni Spallone; Arianna Carnevale; Letizia Mancini; Emiliano Schena; Rocco Papalia; Michael Tobias Hirschmann;

Kinematic alignment doesn't tell the whole story: It's time for kinetic alignment

Abstract

Abstract Kinematic alignment is increasingly adopted in total knee arthroplasty (TKA) as a patient‐specific strategy to restore native joint anatomy. However, its reliance on static radiographic measurements may not adequately reflect real‐world functional biomechanics. This editorial underscores the importance of complementing static assessment with kinetic principles. This emerging concept, referred to as kinetic alignment, integrates dynamic parameters such as the dynamic hip‐knee‐ankle angle, knee adduction moment, ground reaction forces, and muscle forces to better characterise in vivo joint loading. These kinetic variables provide critical insight into joint loading during real‐life activities and may offer greater predictive value for implant performance and patient satisfaction. Continued emphasis on static alignment targets may overlook key elements of in vivo knee function. Incorporating kinetic data into preoperative planning could support more tailored surgical decisions, helping to mitigate risks related to malalignment, overloading, and suboptimal outcomes. The editorial advocates for expanding the concept of alignment beyond static geometry, including both motion and load, and encouraging the orthopaedic and biomechanical communities to adopt a more functional and individualised perspective in TKA planning.

Keywords

Editorial, Knee Joint, Humans, Range of Motion, Articular, Arthroplasty, Replacement, Knee, Biomechanical Phenomena

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green
hybrid