A clinical comparison of patellar tracking using the transepicondylar axis and the posterior condylar axis

Two different methods for femoral component rotation in total knee arthroplasty (TKA) were compared with regard to the need for lateral retinacular release and 3-year follow-up knee society scores of both patellofemoral function and 3-year radiographs of the patella. The posterior condylar axis was used in 1322 consecutive primary TKAs, and the transepicondylar axis (TEA) was used in 1059 consecutive primary TKA. A significant decrease in lateral retinacular release was observed from 56.9% (752 knees) using the posterior condylar axis down to 12.3% (130 knees) using the TEA. No significant differences in knee society scores were observed between the 2 groups with regard to stair climbing, pain, patella radiographs, or range of motion. Routine use of the TEA is recommended for determining femoral component rotation in TKA.