{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:54:09Z","timestamp":1787162049312,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,4,14]],"date-time":"2015-04-14T00:00:00Z","timestamp":1428969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["51205303, 51323007"],"award-info":[{"award-number":["51205303, 51323007"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Science & Technology Pillar Program","award":["2012BAI18B00"],"award-info":[{"award-number":["2012BAI18B00"]}]},{"name":"The Fundamental Research Funds for the Central Universities"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Mal\u2010rotation of the components in total knee arthorplasty (TKA) is a major cause of postoperative complications, with an increased propensity for implant loosening or wear leading to revision. A musculoskeletal multi\u2010body dynamics model was used to perform a parametric study of the effects of the rotational mal\u2010alignments in TKA on the knee loading under a simulated walking gait. The knee contact forces were found to be more sensitive to variations in the varus\u2013valgus rotation of both the tibial and the femoral components and the internal\u2013external rotation of the femoral component in TKA. The varus\u2013valgus mal\u2010rotation of the tibial or femoral component and the internal\u2013external mal\u2010rotation of the femoral component with a 5\u00b0 variation were found to affect the peak medial contact force by 17.8\u201353.1%, the peak lateral contact force by 35.0\u201388.4% and the peak total contact force by 5.2\u201318.7%. Our findings support the clinical observations that a greater than 3\u00b0 internal mal\u2010rotation of the femoral component may lead to unsatisfactory pain levels and a greater than 3\u00b0 varus mal\u2010rotation of the tibial component may lead to medial bone collapse. These findings determined the quantitative effects of the mal\u2010rotation of the components in TKA on the contact load. The effect of such mal\u2010rotation of the components of TKA on the kinematics would be further addressed in future studies. \u00a9 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. 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