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Open research questions in Total Knee Arthroplasty Outcomes

223 unresolved questions extracted from the limitations and future-work sections of 715 Total Knee Arthroplasty Outcomes papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Developing a subject-specific finite element model that accurately represents the anatomy and biomechanics of the TKA knee. Validating the model using in vivo fluoroscopic measurements. Interpreting the results of the simulations to understand the relationship between ligament laxity and joint gap behavior.

    Ligament-dependent joint gap behavior reveals limitations of gap-based tissue balancing in total knee arthroplasty · 2026 · DOI

  • Investigating the effects of different prosthetic configurations on joint gap behavior, - Examining the relationship between ligament laxity and joint gaps in a larger population, - Developing more advanced models to simulate intraoperative laxity assessment

    Ligament-dependent joint gap behavior reveals limitations of gap-based tissue balancing in total knee arthroplasty · 2026 · DOI

  • The effect of osteophyte burden on medial gap behavior in total knee arthroplasty remains poorly defined. The traditional workflow of osteophyte excision during total knee arthroplasty relies heavily on subjective intraoperative assessment. There is a need for a quantitative, biology-guided predictor of coronal plane correction and knee balance.

    Medial expected gap (mEG): a quantitative, biology-guided predictor of coronal plane correction and knee balance in robotic functionally aligned total knee arthroplasty · 2026 · DOI

  • Therefore, although mEG demonstrated consistent associa- tions with coronal correction and all knees achieved the pre- defined acceptable balance criteria without formal medial soft-tissue release, whether these intraoperative findings translate into differences in PROMs, patient satisfaction, or longer-term outcomes remains to be established.

    Medial expected gap (mEG): a quantitative, biology-guided predictor of coronal plane correction and knee balance in robotic functionally aligned total knee arthroplasty · 2026 · DOI

  • Further research could investigate the clinical outcomes and intervention effects of joint fibrosis - Studies could explore the relationship between joint fibrosis and other conditions, such as arthritis

    Joint fibrosis research from a multi-joint perspective: a bibliometric analysis, 2000–2025 · 2026 · DOI

  • The lack of a systematic characterization of the overall research landscape of joint fibrosis. The inconsistent use of diagnostic thresholds and severity classifications in prior studies. The need for a comprehensive analysis of publication output, bibliographic impact, and collaboration patterns in joint fibrosis research.

    Joint fibrosis research from a multi-joint perspective: a bibliometric analysis, 2000–2025 · 2026 · DOI

  • There is a lack of understanding of the impact of longitudinal changes in spatially resolved trabecular bone texture on the prediction of incident radiographic knee osteoarthritis. The current management of knee OA has limitations, including the lack of disease-modifying treatment.

    Spatially resolved longitudinal changes in tibial subchondral trabecular bone texture for exploratory prediction of incident knee osteoarthritis · 2026 · DOI

  • Further studies are needed to confirm the findings. Research on the optimal magnitude of correction after MOWHTO is needed. Studies on the long-term outcomes of MOWHTO in patients with advanced knee osteoarthritis are necessary.

    Excessive tibial valgus was not associated with worse 5-year clinical outcomes after medial opening-wedge high tibial osteotomy for advanced knee osteoarthritis: a retrospective cohort study · 2026 · DOI

  • The optimal magnitude of correction after medial opening-wedge high tibial osteotomy is unclear. There is limited evidence on the association between excessive tibial valgus and clinical outcomes after the procedure.

    Excessive tibial valgus was not associated with worse 5-year clinical outcomes after medial opening-wedge high tibial osteotomy for advanced knee osteoarthritis: a retrospective cohort study · 2026 · DOI

  • Further studies are needed to validate the sensor algorithm and manufacturer-defined threshold, - Research on the long-term effects of quantifiable APE monitoring is needed, - Studies with larger sample sizes are required to detect differences in DVT incidence

    Quantifiable ankle pump exercise monitoring for early postoperative rehabilitation after hip and knee arthroplasty: an exploratory randomized controlled trial · 2026 · DOI

  • VR-psychoeducation probably results in lower pain at 4 weeks (moderate COE; k=1), and VR-distraction may result in 6 months (low COE; k=1), whereas VR-DAE produced mixed findings (k=2; very low COE).

    Extended Reality Interventions for Osteoarthritis of the Knee and Recovery After Total Knee Arthroplasty: Systematic Review and Meta-Analyses · 2026 · DOI

  • Background Current guidelines recommend delaying elective surgery after coronary revascularization, but the relationship between timing for total joint arthroplasty (TJA) and postoperative outcomes remains unclear.

    Postoperative Outcomes by Timing of Total Hip and Knee Arthroplasty Following Coronary Revascularization · 2026 · DOI

  • These findings support further investigation of ΔTBT as a candidate imaging marker but do not establish clinical utility.

    Spatially resolved longitudinal changes in tibial subchondral trabecular bone texture for exploratory prediction of incident knee osteoarthritis · 2026 · DOI

  • Quantifiable monitoring may improve exercise delivery, but its clinical value remains uncertain.

    Quantifiable ankle pump exercise monitoring for early postoperative rehabilitation after hip and knee arthroplasty: an exploratory randomized controlled trial · 2026 · DOI

  • Robotic-assisted (RA) TKA with functional alignment (FA) allows precise control of PTS, but the clinical relevance of small variations in achieved postoperative PTS remains unclear.

    Association Between Achieved Postoperative Posterior Tibial Slope and Flexion–Extension Mechanics in Robotic-Assisted Total Knee Arthroplasty · 2026 · DOI

  • BACKGROUND: Eccentric contraction training may be associated with improved functional recovery after total knee arthroplasty (TKA), but its effects on pain, range of motion, and patient-reported outcomes during the early postoperative period remain unclear.

    The Role of Eccentric Contraction Training in the Postoperative Rehabilitation of Patients With Total Knee Arthroplasty · 2026 · DOI

  • Robot-assisted orthopedic surgery has garnered significant attention, yet comprehensive bibliometric an d visualization analyses in this field remain scarce.

    Global research hotspots and emerging trends in orthopedic robotic surgery: a comprehensive bibliometric analysis · 2026 · DOI

  • However, its efficiency compared with conventional manual methods in real-world NHS practice remains debated.

    Robotic-assisted hip and knee replacement in NHS scotland: trends and efficiency implications (2020–2024) · 2026 · DOI

  • Surgeon handedness may influence prosthetic alignment in conventional manual total knee arthroplasty (CM-TKA), but whether robotic assistance mitigates this effect remains unclear.

    Mako robot-assisted total knee arthroplasty mitigates the impact of surgeon handedness · 2026 · DOI

  • The impact of a surgeon’s routine operative experience on outcomes in robot-assisted total knee arthroplasty (RATKA) remains unclear.

    The impact of the primary surgeon’s routine surgical experience on the clinical efficacy of robot-assisted knee arthroplasty · 2026 · DOI

  • Prospective, comparative studies with extended follow-up are warranted to validate long-term outcomes and further optimize patient-centered care.

    Patient-reported outcomes of kinematically aligned robotic total knee replacement: a single center, single surgeon experience · 2026 · DOI

  • Limited evidence exists regarding patient-centered outcomes following robotic-assisted KA-TKA.

    Patient-reported outcomes of kinematically aligned robotic total knee replacement: a single center, single surgeon experience · 2026 · DOI

  • Robotic total knee arthroplasty (TKA) enables repeated intraoperative quantification of preoperative alignment, flexion deformity, and medial and lateral compartment gaps in extension and at 90° flexion before component positioning, but the preoperative patterns guiding functional-alignment planning remain incompletely characterized.

    Preoperative gap phenotypes in functionally aligned robotic total knee arthroplasty: derivation and internal coherence of a driver-based classification · 2026 · DOI

  • Long-term survivorship superiority and broad cost-effectiveness remain insufficiently proven.

    Robotic-assisted total knee arthroplasty: accuracy, clinical outcomes, complications, learning curve and cost-effectiveness: a critical clinical review · 2026 · DOI

  • The types of device problems reported for different robotic arthroplasty platforms have not been characterised using Australian national surveillance data.

    Failure modes of robotic-assisted arthroplasty platforms in Australia: a descriptive analysis of TGA adverse event reports · 2026 · DOI

Most-cited papers in Total Knee Arthroplasty Outcomes

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223 open questions have been extracted from the limitations and future-work passages of 715 Total Knee Arthroplasty Outcomes papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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