Kinematic vs Mechanical In TKA…Drumroll…No Difference

It’s the knee alignment debate that just won’t quit. On one side, the mechanical alignment (MA) traditionalists, armed with decades of data and the comfort of neutral axes. On the other, the kinematic alignment (KA) enthusiasts, promising more “natural” knees and fewer soft-tissue releases. If this were a heavyweight fight, you’d expect fireworks.

Instead, the latest round — a Level-I RCT published August 19, 2025, in Knee Surgery, Sports Traumatology, Arthroscopy — ended in what can only be called an orthopedic draw. Here’s the study: “No differences in functional and clinical outcomes after rehabilitation between modified kinematic and mechanical alignment in total knee arthroplasty: A randomized controlled trial.”