Total knee arthroplasty alignment technology: visual analysis of the latest research hotspots

• The United States leads in total knee arthroplasty alignment research, with the University of California as the top institution and Howell, Stephen M as the most prolific author. • Kinematic alignment and robotic navigation are emerging as key research hotspots in total knee arthroplasty alignment techniques. • Despite advances in computer-assisted navigation and patient-specific instrumentation, no optimal alignment technique has been universally accepted. • Future research should focus on robot-assisted navigation, patient satisfaction, long-term survival, and patient-specific alignment to improve outcomes.