Open Access

This article has an erratum: [https://doi.org/10.1051/sicotj/2022017]


Table 1

Functional Alignment Philosophy Protocol Guidelines for the varus morphotype.

Parameter Target
Final coronal alignment (HKA) 174°–180°
Final sagittal alignment with gravity only 0° ± 5°
Femur
Varus/valgus* 3° varus to 6° valgus
Flexion* 0°–10°
Rotation (PCA) 0° IR–6°ER
Transepicondylar axis (TEA) 3° IR–6° ER
Tibia
Varus/valgus* 0°–6° varus
Slope* 0°–3° (depends if CR/CS or PS)
Rotation Manual
Combination of Akagi’s line, anatomic fit and floating method
JLO and height JLO orientation to not be changed to different phenotype (CPAK)
Final joint line height ±3 mm from native
Implant sizing Femur – matched to curvature of distal femoral radius to avoid notching and medial-lateral condyles to avoid any overhang or over-stuffing
Tibia – maximal cortical contact with correct rotation with no overhang
Downsized if there is any conflict
Balancing Gaps to match the global thickness of the implant at:
  • 0° extension

  • 90° flexion

Maximum gap difference 1 mm between medial and lateral compartments with a slight lateral laxity acceptable

*Combined values between tibia and femur more important than isolated values. Individual manufacturing guides may vary between implants.

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