Why the Tibia Cut First in Mobile Bearing TKA Technique?

There are three major objectives of surgical technique in total arthroplasty. First is the need to achieve anatomical alignment of 5° to 7° valgus angulation to the mechanical axis. Second is to establish ligamentous balance by achieving careful balance of the flexion and extension gaps within 2 to 3 millimeters of physiological. Finally, is the desire to optimize the potential kinematics of the chosen prosthetic implant. The ≫Tibial Cut First≪ technique follows the original idea of Dr John Insall that establishing the flexion gap was the most important variable in successful total condylar arthroplasty [1] .We will discuss why this approach has become an attractive surgical technique for mobile bearing total knee arthroplasty and how surgical navigation will more accurately place the proximal tibial cut in total knee arthroplasty.