Internal rotation of the femoral component in Kinematically Aligned total knee replacement does increase patella-femoral complications

Studies comparing kinematic alignment (KA) to mechanical alignment (MA) in total knee replacement (TKR) demonstrate components differ significantly in their placement and are patient specific. The femoral component in KA is in average 3° valgus and over 4° internally rotated compared to MA. Surgeons not familiar with KA are conservative regarding internal rotation of femoral components for fear of patellofemoral mal tracking. This study analysed KA-TKRs with regards to femoral component rotation relative to anatomic landmarks and their outcome.