الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The knee is a complex joint that accommodate rotational, angular, and translational forces, the femorotibial articulation surfaces have little inherent stability, so intimate relationship between the ligaments, capsule, and muscles surrounding the joint is required to reinforce it. If any of these structures are compromised, the subsequent biomechanical imbalance can increase the likelihood of additional injury or increased joint loading(1). The behavior of the knee can be unpredictable, however the task of replacing the bone surfaces and balancing the ligaments can be managed by following a logical plan based on alignment correction and ligament release(1). In cases of severe joint osteoarthritis, TKA can be indicated, However, some patients have reported dissatisfaction following surgery(2, 3), as a result of anterior knee pain, stiffness, unexplained swelling, loss of range of motion and changes in proprioception(4). this Poor outcomes is due to improper TKA alignment which will lead to increased wear and early failure(5, 6). Proper soft-tissue balancing during total knee arthroplasty (TKA) is important to ensure long-term success postoperatively; even minimal coronal deformity may necessitate some degree of soft-tissue release for balancing(7) Instability after primary TKA has been reported as one of the major factors for early revision and poor outcomes(7). Ligament release does not cause instability, while Failure to align the knee and release the tight ligaments does cause instability, unreliable function and excessive wear. With this consideration, good instruments and sound implants, the knee can be aligned, balanced, and stabilized even when severe bone destruction and ligament contracture are present(7).