LAUSR

During a conventional measured resection using the posterior reference method for total knee arthroplasty (TKA) in varus knees, proximal tibia is resected from the lateral joint surface for the same thickness as the implant. Distal femur is resected from the worn medial surface for the same thickness as the implant. Posterior femur is resected using the posterior reference method with an external rotation for appropriate degrees. In this situation, although the joint line of the tibia is leveled to the height of lateral joint surface, the posterior joint line of the femur is leveled to the center of medial and lateral posterior condyle, which is a few millimeters lower than the lateral posterior condyle. This discrepancy between the proximal tibia‐posterior femoral joint line causes a tight flexion gap in cruciate‐retaining TKA. Therefore, downsizing of the femur is necessary to adjust the posterior joint line to the level of the lateral condyle.