Introduction: Theoretically, the medial pivot design closely mimics the natural knee kinematics, however, there is no consensus as to whether this corresponds to any difference in terms of patients’ knee function and satisfaction. Hence, the current study was designed as a systematic review to compare the functional outcomes in patients undergone MPTKA versus PS-TKA.

Materials & Methods: Cochrane guidelines were followed to conduct the systematic review. Standard databases (PubMed, Embase and Cochrane) and grey literature were searched for relevant studies in English language, from inception of databases till 17 May 2022, followed by manual searching. Stringent literature screening and data extraction were undertaken by two independent authors and any discrepancy, were resolved by a third senior independent author. The overall quality of included studies was assessed using standard tools and checklists. PRISMA guidelines were used to report the findings.

Results: Systematic literature search revealed 1078 potential publications. 10 studies were included in the final review after stringent screening process. They included a total of 823 knees, out of which 417 received PS-TKA and 405 received MP-TKA (one patient didn’t receive the planned medial pivot intervention). The duration of follow up ranged from 1 to 8 years. 11 different kinds of functional scores were used. Quality of conduct and the risk of bias in studies was variable. Three studies supported better knee function with medial pivot design, however two of them were found to have major shortcomings in design and conduct. Rest of the seven studies didn’t show any significant difference in standard validated functional scores between the two groups.

Conclusion: No significant difference between the two knee designs in terms of functional outcome was found. Hence, there is no functional superiority of medial pivot knee over posterior stabilised knee. 

Anubhav Malhotra finished his basic orthopaedic training in India, topping the university in M.S. (Orthopaedics) examinations. After working as a senior resident for 2 years, he was selected for an International Training Fellowship in Trauma & Orthopaedics at Wirral University Teaching Hospitals NHS Trust, UK. He is currently working as a specialist registrar in Orthopaedics in the same hospital. He has an aptitude for research which is evidenced by his 30 publications in indexed peer-reviewed journals. He has to his credit several national/international oral/poster presentations. He has won the ‘Best Paper award’ five times in various orthopaedic conferences. He has worked his way towards research master’s qualification (MCh) as well from Edge Hill University, UK.