Abstract
The anatomic resection approach is based on the patient's unique anatomy adjusting for worn cartilage or bone loss. The femoral component is aligned around the primary transverse distal femoral axis around which the tibia follows a multi-radius of curvature. The tibia cut is made according to the patient's native anatomy adjusting for worn cartilage and bone loss, and applying an anatomic amount of tibial slope. This technique minimises the need for ligamentous releases to a large degree preserving the competence of the patient's soft tissue. Ligament and capsular releases can be used in difficult cases. Adjustments for the natural varus up to 3 degrees and slope of the tibial bone cut (3 – 10 degrees) further aids in knee balancing. The final alignment may not agree with a neutral hip-knee-ankle mechanical alignment on full length standing x-rays, leaving varus knees in slight varus, and valgus legs in neutral. Since little or no balance is required, this operation can be performed efficiently.
Personalise the reconstruction and alignment as much as possible for each patient. The traditional “one size fits all” method where all patients have a center hip, knee, and ankle alignment needs to be reevaluated and reserved for the valgus leg.
