BACKGROUND: Currently, studies about prosthesis rotational alignment of total knee arthroplasty (TKA) are focused on the rotational landmark location.
OBJECTIVE: To summarize the clinical and basic research progress related to prosthesis rotational alignment in TKA.
METHODS: Clinical articles related to anatomic landmark, location method, matching in rotational alignment and operational precision of prosthesis rotational alignment in TKA were extensively reviewed.
RESULTS AND CONCLUSION: Many studies show that malrotation may lead to various complications, such as anterior knee pain, femoro-tibial and patellofemoral instability, maladjustment of patellar movement trajectory, abnormal gait, accelerated polyethylene wear, premature loosening, subluxation or dislocation, and even need for further revision. All derived data from various sources should be used in prosthesis rotational alignment at tibial and femoral side when operation, individual corrections should be made appropriately, and preoperative CT scan can be used if necessary, so as to improve the TKA outcome and longevity.