Introduction: Axial femorotibial rotation during flexion of the healthy knee has been seen in numerous previous in vitro and in vivo kinematic analyses. With knee flexion, the tibia typically internally rotates relative to the femur, and conversely, externally rotates with knee extension. Previous TKA studies have been limited and have analyzed small numbers of patients, often using non-weight-bearing conditions or only throughout a limited percentage of the entire flexion range. It is assumed that different axial rotation magnitudes and patterns (ie, direction of rotation; internal or external tibial rotation versus the femur) may occur after TKA because of removal or alteration of the cruciate ligaments and failure to exactly duplicate geometry of the medial and lateral femoral and tibial condyles. Computer assisted surgical navigation (CAOS) offers a unique opportunity to evaluate tibial rotation intra-operatively along with numerous other parameters. This report reviewed tibial rotation documented before and after mobile and fixed total knee arthroplasty in a group of patients where the same "tibial cut first" method was utilized with both implants.
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