Flexion space configuration in total knee arthroplasty

Equal resection of the posterior femoral condyles combined with a 90 degree tibial resection results in a trapezoidal flexion space. Two groups of patients were studied; in one group, the flexion space was allowed to remain trapezoidal, whereas in the other group, the anteroposterior femoral resections were externally rotated to allow rectangularization of the flexion space. In the second group, the range of flexion was increased and the incidence of medial tibial pain and zone I radiolucencies decreased. Other than for knees in a hypervalgus position before surgery, the mean amount of rotation required was 3 degrees +/- 0.2 degrees.