Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping Review
<i>Background and Objectives</i>: Total knee arthroplasty (TKA) is one of the most common medical procedures worldwide. However, 10 to 20% of patients are still dissatisfied despite implants and surgical technique advancements. Recently, several medial-stabilized TKAs have been developed...
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MDPI AG
2025-05-01
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| author | Francesco Romano Roberto Rossi Umberto Cottino Matteo Bruzzone Francesco Pirato Federica Rosso |
| author_facet | Francesco Romano Roberto Rossi Umberto Cottino Matteo Bruzzone Francesco Pirato Federica Rosso |
| author_sort | Francesco Romano |
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| description | <i>Background and Objectives</i>: Total knee arthroplasty (TKA) is one of the most common medical procedures worldwide. However, 10 to 20% of patients are still dissatisfied despite implants and surgical technique advancements. Recently, several medial-stabilized TKAs have been developed in attempts to replicate the native kinematics of the knee. The aim of this scoping review on medial-stabilized TKA inserts—medial congruent (MC) and medial pivot (MP)—is to focus on their clinical outcomes and the role of the posterior cruciate ligament (PCL), aiming to systematically map the existing research and highlight current knowledge gaps. <i>Materials and Methods</i>: A search of the PubMed, Embase and Cochrane databases was performed to identify relevant studies on the kinematics and outcomes of medial pivot (MP) or medial congruent (MC) inserts. The following Mesh terms were used in combination with the Boolean operators “AND” and “OR”: “total knee arthroplasty”, “total knee replacement”, “medial pivot”, “medial congruence”, “outcomes” and “kinematic”. Original studies reporting on clinical outcomes assessed with validated patient-reported scales, surgical techniques and reoperation rates for any reason with a minimum follow-up of 18 months were included. <i>Results</i>: A total of 39 articles met the inclusion criteria, accounting for 6143 total knee replacements. The overall reoperation-free survivorship rate was 98.4% (6047 out of 6143 knees) at a weighted average follow-up of 6.3 years (range 1.5–15.2 years, SD 0.7). Both MP and MC inserts demonstrated good outcomes, with no differences between groups. Few studies evaluated the role of the PCL in MP and MC inserts, with no differences in terms of clinical outcomes between retaining and sacrificing the PCL. <i>Conclusions</i>: MS-TKA demonstrated good outcomes in the literature independently of the specific design (medial pivot or medial congruent). Different possible biases may be present when evaluating the outcomes of these inserts, including different types of alignment and soft tissue balancing philosophies. |
| format | Article |
| id | doaj-art-5d7f450a730b4b4e93f6a76da08daa0a |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj-art-5d7f450a730b4b4e93f6a76da08daa0a2025-08-20T03:47:58ZengMDPI AGMedicina1010-660X1648-91442025-05-0161584410.3390/medicina61050844Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping ReviewFrancesco Romano0Roberto Rossi1Umberto Cottino2Matteo Bruzzone3Francesco Pirato4Federica Rosso5Department of surgery, Università degli Studi di Torino, Via Po 8, 10100 Torino, ItalyAO Ordine Mauriziano, Department of Orthopaedics and Traumatology, University of Torino, Largo Turati 62, 10128 Torino, ItalyAO Ordine Mauriziano, Department of Orthopaedics and Traumatology, University of Torino, Largo Turati 62, 10128 Torino, ItalyAO Ordine Mauriziano, Department of Orthopaedics and Traumatology, University of Torino, Largo Turati 62, 10128 Torino, ItalyDepartment of surgery, Università degli Studi di Torino, Via Po 8, 10100 Torino, ItalyAO Ordine Mauriziano, Department of Orthopaedics and Traumatology, University of Torino, Largo Turati 62, 10128 Torino, Italy<i>Background and Objectives</i>: Total knee arthroplasty (TKA) is one of the most common medical procedures worldwide. However, 10 to 20% of patients are still dissatisfied despite implants and surgical technique advancements. Recently, several medial-stabilized TKAs have been developed in attempts to replicate the native kinematics of the knee. The aim of this scoping review on medial-stabilized TKA inserts—medial congruent (MC) and medial pivot (MP)—is to focus on their clinical outcomes and the role of the posterior cruciate ligament (PCL), aiming to systematically map the existing research and highlight current knowledge gaps. <i>Materials and Methods</i>: A search of the PubMed, Embase and Cochrane databases was performed to identify relevant studies on the kinematics and outcomes of medial pivot (MP) or medial congruent (MC) inserts. The following Mesh terms were used in combination with the Boolean operators “AND” and “OR”: “total knee arthroplasty”, “total knee replacement”, “medial pivot”, “medial congruence”, “outcomes” and “kinematic”. Original studies reporting on clinical outcomes assessed with validated patient-reported scales, surgical techniques and reoperation rates for any reason with a minimum follow-up of 18 months were included. <i>Results</i>: A total of 39 articles met the inclusion criteria, accounting for 6143 total knee replacements. The overall reoperation-free survivorship rate was 98.4% (6047 out of 6143 knees) at a weighted average follow-up of 6.3 years (range 1.5–15.2 years, SD 0.7). Both MP and MC inserts demonstrated good outcomes, with no differences between groups. Few studies evaluated the role of the PCL in MP and MC inserts, with no differences in terms of clinical outcomes between retaining and sacrificing the PCL. <i>Conclusions</i>: MS-TKA demonstrated good outcomes in the literature independently of the specific design (medial pivot or medial congruent). Different possible biases may be present when evaluating the outcomes of these inserts, including different types of alignment and soft tissue balancing philosophies.https://www.mdpi.com/1648-9144/61/5/844total knee arthroplastymedial pivotmedial congruenceoutcomes |
| spellingShingle | Francesco Romano Roberto Rossi Umberto Cottino Matteo Bruzzone Francesco Pirato Federica Rosso Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping Review Medicina total knee arthroplasty medial pivot medial congruence outcomes |
| title | Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping Review |
| title_full | Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping Review |
| title_fullStr | Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping Review |
| title_full_unstemmed | Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping Review |
| title_short | Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping Review |
| title_sort | medial congruent and medial pivot inserts in total knee arthroplasty a scoping review |
| topic | total knee arthroplasty medial pivot medial congruence outcomes |
| url | https://www.mdpi.com/1648-9144/61/5/844 |
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