Background
Kinematically aligned (KA) total knee arthroplasty (TKA) has emerged as an alternative approach to the intraoperative alignment targets of mechanically aligned (MA) TKA. While the clinical outcomes of the two philosophies have been investigated, further investigation is required to quantify exactly how the two philosophies differ in their approach to correcting the deformities encountered in osteoarthritic knees such as fixed flexion deformities (FFD) and coronal malalignment. The aim of this paper was to compare MA and KA philosophies in TKA in terms of the intra-operative correction of FFD and coronal malalignment and quantify the way in which each philosophy achieves a well-balanced knee that can reach full extension.