Abstract
Balanced gaps and proper rotation are felt to be essential for optimum range of motion, stability, and patellar tracking in total knee arthroplasty. The purpose of this study is to assess, using computed tomography, the rotation of femoral and tibial components in fresh-frozen human cadaver knees that have been balanced using nanosensor trials while also observing how this rotation affects measured compartment loads and requirement for ligament balancing adjustment. We found that minor degrees of rotational malalignment of the femur and tibia were common using standard instrumentation and measured resection technique. Quantitative balance and rotational congruence are aided by nanosensor guidance, and femoral malrotation of up to 8° does not appear to affect compartment loads significantly as long as rotational congruity is present.