Personalized alignment – the importance of inter-continental research for improving patient outcomes today and tomorrow

Total knee arthroplasty (TKA) has become one of the most widely performed procedures for end-stage osteoarthritis, yet patient satisfaction continues to lag behind that of hip replacement. Advances in robotics and artificial intelligence have increased surgical precision, but improved accuracy alone does not guarantee better outcomes. The challenge lies in defining appropriate alignment and balancing strategies that respect each patient's unique anatomy and soft-tissue characteristics rather than relying on uniform targets. Personalized alignment has emerged as a promising concept, aiming to restore individual bony geometry and preserve native laxity patterns across all planes. However, questions remain about what constitutes “normal” versus “pathologic,” especially given anatomical and demographic differences between populations. Data derived largely from Caucasian cohorts may not be directly transferable to Asian patients, whose morphologies often differ substantially. This underscores the need for region-specific research, robust data collection, and harmonized workflows supported by advanced analytic systems. Only through global collaboration and objective evidence can reliable boundaries for personalized techniques be established. By integrating precision technology with truly individualized surgical planning, the next phase of TKA development seeks to raise functional outcomes and patient satisfaction worldwide.