Abstract Purpose Patellofemoral kinematics is crucial for patient satisfaction following total knee arthroplasty (TKA). A postoperative patellar tilt greater than 5° has been associated with inferior clinical outcomes. While a femoral component external rotation beyond 3° is generally protective against patellar tilt, personalized alignment may not consistently reach this threshold. The aim of this study is to (1) assess the incidence of postoperative patellar tilt >5° following TKA with personalized alignment and (2) identify preoperative and intraoperative factors associated with this complication. Methods This comparative retrospective study included 316 primary TKAs Attune (Johnson p = 0.02), right‐sided surgery (OR: 2.63; p = 0.02) and PS implants (OR: 2.59; p = 0.04) as independent risk factors. Conclusion Personalized alignment, the subvastus approach, and cruciate‐retaining implants appear to reduce the risk of postoperative patellar tilt. Level of Evidence Level III, retrospective cohort study.
Guen et al. (Fri,) studied this question.