{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T09:45:58Z","timestamp":1783158358936,"version":"3.54.6"},"reference-count":43,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Proper femoral component rotation in total knee arthroplasty (TKA) is important, given the prognostic impact of a poorly positioned component. The purpose of this observational study was to determine the incidence of femoral component malrotation using posterior condylar axis (PCA) referencing. A total of 100 knees in 92 patients with varus gonarthritis of the knee undergoing primary TKA using a standard medial parapatellar approach were evaluated intraoperatively. After distal femoral resection, the standard femoral sizing guide referencing the posterior condylar axis was used to set femoral component rotation. This was then compared with both the transepicondylar (TEA) and trochlear anteroposterior axes (TRAx). Disparites were recorded and corrected in line with the epicondylar axis. Rotational adjustment for addition of further external rotation was made in 13 (13.0%) cases. In seven cases, the medial pin sites were raised between 1 and 3\u2009mm, and in six cases, the lateral pin site was lowered between 1 and 3\u2009mm (based on risk of notching the femoral cortex). It is critical to not rely exclusively on the PCA to confirm rotational positioning of the femoral component as predicted by posterior condylar referencing guides. Intraoperative adjustment and confirmation using the TEA and TRAx occurred in 13% of primary TKA cases, which might have, otherwise, had a significant effect on the clinical outcome.<\/jats:p>","DOI":"10.1055\/s-0039-1688931","type":"journal-article","created":{"date-parts":[[2019,5,20]],"date-time":"2019-05-20T22:53:11Z","timestamp":1558392791000},"page":"971-977","source":"Crossref","is-referenced-by-count":4,"title":["Incidence of Femoral Component Malrotation Using Posterior Condylar Referencing in Total Knee Arthroplasty"],"prefix":"10.1055","volume":"33","author":[{"given":"Diana K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Grosso","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Trofa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian J.","family":"Sonnenfeld","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. John","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshan P.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Geller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2019,5,20]]},"reference":[{"issue":"366","key":"ref1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/00003086-199909000-00019","article-title":"Effect of rotational alignment on patellar tracking in total knee arthroplasty","author":"M Akagi","year":"1999","journal-title":"Clin Orthop Relat Res"},{"issue":"286","key":"ref2","first-page":"40","article-title":"Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis","author":"R A Berger","year":"1993","journal-title":"Clin Orthop Relat Res"},{"issue":"462","key":"ref3","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/BLO.0b013e3180dc92e7","article-title":"Bone landmarks are more reliable than tensioned gaps in TKA component alignment","volume":"462","author":"H Hanada","year":"2007","journal-title":"Clin Orthop Relat Res"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s00167-011-1750-3","article-title":"Comparison of the tibiofemoral rotational alignment after mobile and fixed bearing total knee arthroplasty","volume":"20","author":"D Kim","year":"2012","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"09","key":"ref5","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1007\/s00167-011-1499-8","article-title":"The effect of femoral component rotation on the kinematics of the tibiofemoral and patellofemoral joints after total knee arthroplasty","volume":"19","author":"A M Merican","year":"2011","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"08","key":"ref6","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/j.arth.2004.08.005","article-title":"The functional flexion-extension axis of the knee corresponds to the surgical epicondylar axis: in vivo analysis using a biplanar image-matching technique","volume":"20","author":"T Asano","year":"2005","journal-title":"J Arthroplasty"},{"issue":"07","key":"ref7","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/S0883-5403(98)90036-5","article-title":"The posterior condylar angle in osteoarthritic knees","volume":"13","author":"F M Griffin","year":"1998","journal-title":"J Arthroplasty"},{"issue":"331","key":"ref8","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/00003086-199610000-00006","article-title":"Rotational landmarks and sizing of the distal femur in total knee arthroplasty","author":"P L Poilvache","year":"1996","journal-title":"Clin Orthop Relat Res"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"873","DOI":"10.2106\/00004623-198769060-00012","article-title":"The anatomy and functional axes of the femur","volume":"69","author":"Y Yoshioka","year":"1987","journal-title":"J Bone Joint Surg Am"},{"issue":"176","key":"ref10","first-page":"95","article-title":"Preliminary experience with a total knee prosthesis with porous coating used without cement","author":"D S Hungerford","year":"1983","journal-title":"Clin Orthop Relat Res"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S0883-5403(05)80211-6","article-title":"Flexion space configuration in total knee arthroplasty","volume":"10","author":"R S Laskin","year":"1995","journal-title":"J Arthroplasty"},{"issue":"09","key":"ref12","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.2106\/00004623-199509000-00006","article-title":"Femoral rotational alignment, based on the anteroposterior axis, in total knee arthroplasty in a valgus knee. 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