Coronal alignment after total knee arthroplasty

Recent studies have challenged the long-held notion that neutral mechanical alignment after total knee arthroplasty leads to optimal function and survivorship. The ideal alignment for function and survivorship may actually be different. Kinematic alignment, where components are implanted to re-create the natural flexion/extension axis of the knee, may lead to improved functional results. Residual varus alignment may not adversely impact survivorship provided the tibial component is implanted in neutral alignment.