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Similar results with kinematic and mechanical alignment applied in total knee arthroplasty

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

A Correction to this article was published on 09 April 2020

This article has been updated



This meta-analysis compared the results of kinematic alignment (KA) and mechanical alignment (MA) applied in total knee arthroplasty (TKA).


Randomized controlled trials and cohort studies comparing functional, radiological, and perioperative results and complications in TKA with KA and MA were collected from databases and included in the analysis.


Nine trials were included. KA showed a better performance in terms of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (mean difference [MD] =  − 9.06, 95% confidence interval [CI] − 14.69, − 3.42) and Oxford knee score (OKS) (MD = 4.72, 95% CI 0.24, 9.21); however, the Knee Society score (KSS), knee injury and osteoarthritis outcome score (KOOS), EuroQoL 5-dimension questionnaire (ED-5D), range of motion, and complications were similar for KA and MA (n.s.). KA resulted in slightly more varus alignment in the tibia [mechanical medial proximal tibial angle (mMPTA) MD = − 2.45, 95% CI − 2.89, − 2.01) and more valgus alignment in the femur (mLDFA MD = − 2.06, 95% CI − 2.48, − 1.65) than MA (P < 0.05), but showed similar results in terms of the joint line orientation angle (JLOA) (MD = 0.54, 95% CI − 2.59, 3.66), hip–knee–ankle angle (HKA), anatomical knee angle (AKA), femoral flexion–extension angle (FFA), and tibial slope (TS). The preoperative results, including the incision length, hospital stay, and changes in hemoglobin, were also similar.


KA achieved functional, radiological, and perioperative results similar to those of MA and did not increase the complication rate. KA is an acceptable and satisfactory method for application in TKA.

Level of evidence


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Availability of data and material

The data sets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Change history

  • 09 April 2020

    Our article entitled “Similar results with kinematic and mechanical alignment applied in total knee arthroplasty.


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We would like to thank the staff of the Department of Orthopedic Surgery, West China Hospital, for their support and American Journal Experts for their assistance with the language of the manuscript.


No external funding was received for this study.

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ZYL collected and analyzed data and wrote the manuscript. KZ, LP, and QWS analyzed data. ZKZ helped to draft the manuscript. All authors reviewed the final manuscript. All authors agree to be accountable for all aspects of the work.

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Correspondence to Zongke Zhou.

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Luo, Z., Zhou, K., Peng, L. et al. Similar results with kinematic and mechanical alignment applied in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 28, 1720–1735 (2020).

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