The EKA Femoral Rotation Focus Group has not identified a single best reference method to determine femoral component rotation , but surgeons mostly prefer the measured resection technique using at least two l and marks for cross-checking the rotation .
Malrotation of the femoral component after primary total knee arthroplasty ( TKA ) is one of the most important problems leading to painful TKA requiring revision surgery .
A comprehensive systematic review of the literature was performed to present current evidence on how to optimally place the femoral component in TKA .
Kinematic femoral alignment with gap balancing and patient-specific instrumentation in total knee arthroplasty: a randomized clinical trial
While patient-specific instrumentation ( PSI ) in total knee arthroplasty ( TKA ) allows for transfer of the preoperative plan onto bony l and marks , the soft tissue balancing is not affected . The goals of this r and omized clinical trial were to compare PSI and the measured resection technique ( conventional ) with PSI and the gap balancing technique .  Fifty patients were r and omized to TKA with conventional PSI ( PSI-S ) ( n = 25 ) or to PSI with additional gap balancing ( PSI-GB ) ( n = 25 ) . All patients were clinical ly examined at 3 and 12 months postoperatively . Data on the range of motion , the Knee Society Score , the Western Ontario and McMasters Universities Osteoarthritis Index , the High-Flexion Knee Score ( HFKS ) , and the Forgotten Joint Score ( FJS ) were compiled at follow-up . Statistically significant improvements were found for all clinical parameters in the PSI-GB group compared to the PSI-S group at 3 months postoperatively and for FS , FJS , and HFKS at 12 months . However , the relevance of these differences , as well as their effect on long-term outcomes , needs to be evaluated further . In conclusion , patient-specific instrumentation combined with gap balancing yielded good early clinical outcomes
The EKA Femoral Rotation Focus Group has not identified a single best reference method to determine femoral component rotation , but surgeons mostly prefer the measured resection technique using at least two l and marks for cross-checking the rotation .
Malrotation of the femoral component after primary total knee arthroplasty ( TKA ) is one of the most important problems leading to painful TKA requiring revision surgery .
A comprehensive systematic review of the literature was performed to present current evidence on how to optimally place the femoral component in TKA .