Is There a Gold Standard for Rotational Alignment of the Tibial Component During

INTRODUCTION A successful total knee arthroplasty (TKA) is dependent on many factors, but component alignment is particularly critical. Aligning the femoral component parallel to the transepicondylar axis is generally regarded as the optimal rotational position, since it has been shown to produce a balanced joint, optimize patellar tracking, and minimize patellofemoral shear forces [1,2] the femur, a gold standard for rotational alignment of the tibial component has not been established. A wide variety of landmarks can be used during surgery including the medial border of tibial tubercle, the medial third of the tibial tubercle, the projected femoral transepicondylar axis, the PCL attachment, and the transverse axis of the tibia [3,4]. It is not currently understood how the choice of one of these alignments over the others impacts the stability or kinematics of the TKA knee. purpose of this study was to examine the relationship of tibial component rotational alignment to passive knee kinematics and stabil