Medial-pivot total knee arthroplasty is associated with reduced perceived difficulty during stair descent…

Cohort studyJournal of orthopaedic science : official journal of the Japanese Orthopaedic Association· Jul 2026

Medial-pivot total knee arthroplasty is associated with reduced perceived difficulty during stair descent than conventional designs: A propensity-matched cohort study.

Kazuhisa Hatayama, Satoshi Nonaka, Kazuya Okada … Masanori Terauchi

ArthroplastyCohort studyTreatmentQ3IF 1.5

Medial-pivot total knee arthroplasty is associated with less perceived difficulty during stair descent.

Medial-pivot total knee arthroplasty is associated with reduced perceived difficulty during stair descent than conventional designs: A propensity-matched cohort study.

Kazuhisa Hatayama … Masanori Terauchi

Journal of orthopaedic science · Jul 2026 · Q3 in Orthopedics

Background

Implant design in total knee arthroplasty (total knee arthroplasty) may influence knee stability and muscle demand during stair descent.

Purpose

This study compared postoperative stair-descent ability between medial-pivot (medial-pivot) total knee arthroplasty and conventional cruciate-retaining (cruciate-retaining) and posterior-stabilized (posterior-stabilized) total knee arthroplasty.

Methods

Female patients who underwent unilateral medial-pivot (EVOLUTION, MicroPort Orthopedics) or conventional cruciate-retaining/posterior-stabilized total knee arthroplasty (ATTUNE, DePuy Synthes) were retrospectively reviewed and propensity score-matched (1:1) for age, body mass index, and preoperative handgrip strength.

n = 164 patients

27%

Results

27%

vs. 45%

fewer patients with medial-pivot knee replacement reported difficulty descending stairs

n = 164 patients

More results

Postoperative ROM in both knees was comparable between groups.

More results

In the conventional group, patients who descended using a step-over-step pattern demonstrated significantly greater preoperative handgrip strength and higher postoperative quadriceps strength than those who descended using a step-to-step pattern; however, no such differences were observed in the medial-pivot group.

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Conclusion · 1 of 2

Medial-pivot total knee arthroplasty was associated with less difficulty during stair descent than conventional cruciate-retaining/posterior-stabilized total knee arthroplasty.

Conclusion · 2 of 2

Although the frequencies of step-over-step descent were similar, medial-pivot total knee arthroplasty enabled effective stair descent despite lower quadriceps strength, suggesting reduced muscular demand during weight-bearing flexion.

Medial-pivot total knee arthroplasty is associated with reduced perceived difficulty during stair descent than conventional designs: A propensity-matched cohort study.

Medial-pivot total knee arthroplasty is associated with reduced perceived difficulty during stair descent than conventional designs: A propensity-matched cohort study.

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