Femoral Alignment and Femoral Rotation

With an aging population and an increasing number of primary total knee arthroplasties (TKA) being performed, the need for revision operations persists despite advancements in technology and tools for performing primary TKAs. The goals of revision TKA, much like primary TKA, are to relieve pain and restore function. This chapter outlines the relevant anatomy and axes of the distal femur and reviews the gait cycle and knee biomechanics; subsequently, this chapter reviews various techniques employed to establish proper coronal and axial alignment of the femoral component in order to facilitate restoration of adequate osseous and ligamentous stability throughout the gait cycle, particularly in the revision setting.