Rotational adjustment of the femoral component in total knee arthroplasty influences patellar tracking. Sixty patients underwent TKA; the femoral component was placed parallel to the epicondylar axis in 30 patients and the femoral component was placed in 3 degrees external rotation to the posterior condylar axis in 30 patients. The epicondylar axis was identified using an image-guided navigation system. Mean patellar shift was 2.65 degrees for the computer assisted group and 3.50 degrees for the control group. Mean patellar tilt was 4.88 degrees for the computer assisted group and 6.68 degrees for the control group. Aligning the femoral component parallel to the epicondylar axis leads to significantly better patellar tracking.
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