Seven cuts to the perfect total knee.

Area of Science:

• Orthopedic Surgery
• Biomechanics

Background:

• Total knee replacement (TKR) involves complex bone resections.
• Each of the seven standard bone cuts presents unique surgical considerations.
• Improper execution of cuts can negatively impact TKR outcomes.

Purpose of the Study:

• To detail the critical aspects of each of the seven bone cuts in total knee replacement.
• To elucidate the biomechanical implications of each cut on overall TKR success.

Main Methods:

• Review of the standard surgical technique for each of the seven bone cuts in TKR.
• Analysis of the anatomical and biomechanical consequences of each resection.
• Identification of common errors and best practices for each cut.

Main Results:

• Distal femoral cut establishes leg alignment; 5° valgus is optimal.
• Anterior femoral cut dictates component rotation, influencing patellar tracking.
• Posterior femoral and tibial cuts, along with chamfer cuts, are vital for flexion gap and ligament preservation.
• Tibial cut requires precise slope (3° posterior) and rotation to avoid errors affecting tracking and stability.
• Patellar cut depth and component placement (medial/superior) are key; lateral release should preserve blood supply.

Conclusions:

• Each of the seven bone cuts in TKR requires meticulous attention to detail.
• Accurate execution of femoral, tibial, and patellar cuts is essential for optimal TKR function and patient outcomes.
• Understanding the interdependencies of these cuts is critical for surgical success.