Abstract
While the number of primary TKAs completed in the United States is expected to increase dramatically in the years to come, approximately 20% of patients undergoing primary TKA are dissatisfied with the procedure [5, 11]. As such, substantial healthcare resources have been devoted to the development and use of patient-specific instrumentation (PSI), computer navigation, robotics, and other tools that help achieve a neutrally aligned TKA in the coronal plane [1, 2, 14]. On the other hand, some investigators support a different approach: The concept of a kinematically aligned TKA [6, 8–10]. In general terms, a neutrally aligned TKA cuts the distal femur and proximal tibia 90° to the respective mechanical axes, while a kinematically aligned TKA incorporates 3° of varus into the tibia and an additional 3° of valgus into the femur. However, there remains considerable controversy in this area, in large measure because of a relative paucity of research comparing the approaches. As such, I have invited two internationally known experts to discuss these two approaches to obtaining a well-aligned TKA – the neutrally aligned and kinematically aligned techniques.
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