Accurate positioning of the femoral component is key to successful TKA surgery. Axial and coronal femoral component alignment can be modified to adjust flexion and extension balance on a patient specific level. To prevent joint instability and poor kinematics, femoral component angular boundaries are utilized by most surgeons. It is unclear however, whether these boundaries are to guide improved component articulation or soft tissue balance. This study investigates the relationship between coronal and axial angular resections, joint balance and outcome in TKA.
The study found that joint balance rather than femoral component alignment had a significant effect on 1-year KOOS outcomes, and that alignment outside of traditional boundaries did not affect the percentage of balanced joints. Accepting outlier alignments may assist surgeons to achieve a higher rate of joint balance and improved patient outcomes.