Surgical strategies to achieve a custom-fit TKA with standard implant technique

Recent trends in implant design have been geared toward taking individual differences in knee anatomy into consideration and modifying implants to accommodate these distinctions. The unique anatomy of the female knee gave birth to sex-specific knee implants and began a new era in implant design. This opened the door for the next progression of patient-specific cutting guides and implants. The current trend in implant design addresses individual variation with 3-D modeling that necessitates preoperative magnetic resonance imaging or computed tomography scans. While these innovations may turn out to be worthwhile, their use is currently limited by their expense and debatable clinical significance. Surgeons should not forget the basic surgical strategies to tailor their surgery to customize the fit of the standard implant. The surgical pearls reviewed here will allow surgeons to better understand sizing and customize every total knee arthroplasty with a patient-specific surgery. [corrected]