Alpert Z, Khury F, Sauder N, Lam AD, Laudes G, Melnic CM, Krueger CA, Schwarzkopf R. Mid-term outcomes of a novel liner design in kinematically-designed cruciate-retaining total knee arthroplasty. World J Orthop 2026; 17(1): 110090 [DOI: 10.5312/wjo.v17.i1.110090]
Corresponding Author of This Article
Zoe Alpert, Research Fellow, Orthopedic Surgery, NYU Langone Health, 380 Second Avenue, New York, NY 10003, United States. zoealpert2@gmail.com
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Orthopedics
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Observational Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 18, 2026 (publication date) through Jan 9, 2026
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Publication Name
World Journal of Orthopedics
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2218-5836
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Alpert Z, Khury F, Sauder N, Lam AD, Laudes G, Melnic CM, Krueger CA, Schwarzkopf R. Mid-term outcomes of a novel liner design in kinematically-designed cruciate-retaining total knee arthroplasty. World J Orthop 2026; 17(1): 110090 [DOI: 10.5312/wjo.v17.i1.110090]
World J Orthop. Jan 18, 2026; 17(1): 110090 Published online Jan 18, 2026. doi: 10.5312/wjo.v17.i1.110090
Mid-term outcomes of a novel liner design in kinematically-designed cruciate-retaining total knee arthroplasty
Zoe Alpert, Farouk Khury, Nicholas Sauder, Alan D Lam, Greta Laudes, Christopher M Melnic, Chad A Krueger, Ran Schwarzkopf
Zoe Alpert, Farouk Khury, Greta Laudes, Ran Schwarzkopf, Orthopedic Surgery, NYU Langone Health, New York, NY 10003, United States
Farouk Khury, Division of Orthopedic Surgery, Rambam Health Care Campus, The Ruth and Bruce Rappaport Faculty of Medicine, Haifa 3109601, Israel
Nicholas Sauder, Christopher M Melnic, Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
Nicholas Sauder, Christopher M Melnic, Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, MA 02462, United States
Alan D Lam, Chad A Krueger, Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA 19107, United States
Author contributions: Schwarzkopf R conceptualized this study; Alpert Z and Khury F performed statistical analysis and drafted and revised the manuscript; Sauder N and Lam AD collected and organized data from their respective sites; Krueger CA, Melnic CM, and Schwarzkopf R supervised this project and performed the surgeries written about in the study.
Institutional review board statement: Institutional Review Board approval was received before beginning this study, No. i23-00714.
Informed consent statement: As a retrospective study, institutional review board approval allowed the use of anonymized clinical data without individual patient consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: All data will be made available upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zoe Alpert, Research Fellow, Orthopedic Surgery, NYU Langone Health, 380 Second Avenue, New York, NY 10003, United States. zoealpert2@gmail.com
Received: May 29, 2025 Revised: July 18, 2025 Accepted: November 12, 2025 Published online: January 18, 2026 Processing time: 225 Days and 14.1 Hours
Abstract
BACKGROUND
Medial dished (MD) liner designs for cruciate-retaining (CR) total knee arthroplasty (TKA) are a relatively novel development. MD tibial inserts have a more constraining medial side, which allows for more similar kinematics and function to a native knee.
AIM
To evaluate the clinical results and patient-reported outcomes after CR TKA procedures utilizing a kinematically designed medial dish system.
METHODS
A multicenter, retrospective cohort review of 139 primary elective TKAs utilizing a kinematically designed CR Knee System (JOURNEY™ II CR MD; Smith and Nephew, Memphis, TN, United States) at three different institutions with a minimum of two years of follow-up. Demographic information, clinical outcomes, and patient-reported outcome measures were collected and analyzed.
RESULTS
With up to 3.7 years from surgery, overall implant survivorship was 98.6%. There were significant postoperative increases in the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores (17.4 at 6 months, 26.1 points at two years or more, P < 0.001).
CONCLUSION
The combination of high implant survivorship and substantial improvements in patient-reported outcome measures suggests that the medial dish tibial insert represents a safe and effective option within TKA. Additional investigation is necessary to evaluate the long-term survivorship of this design.
Core Tip: This multicenter retrospective review evaluates outcomes following cruciate-retaining total knee arthroplasty using a novel, kinematically designed medial dished tibial insert. With an implant survivorship of 98.6% and significant improvements in subjective outcome measures such as the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, the results of this study suggest this implant design effectively replicates native knee kinematics. These findings support the use of the medial dished tibial insert as a promising option in cruciate-retaining total knee arthroplasty, warranting further long-term investigation.
