Total Knee Arthroplasty (TKA): Step-by-Step Surgical Photo Tour • Step 20 of 24
Surgical Step Description
Verification of central patellofemoral congruency and tracking through complete range of motion without manual digital pressure (‘no thumbs’ rule) to rule out patellar tilt or subluxation.
Master Class Pro-Tip: Intraoperative Pearl
If lateral patellar tilt or subluxation is observed during the ‘no thumbs’ assessment, first re-evaluate femoral and tibial component rotation; a lateral retinacular release from inside-out should only be performed if malrotation has been rigorously excluded.
Master Class Pro-Tip: Unassisted Patellar Tracking & Component Rotation
Curator & Series Attribution
Curated by Dr. Joseph Bernstein, MD (Director of Education) • Managing Editor: Dr. Christian Veillette, MD • OrthopaedicsOne Surgical Education Series • Adult Reconstruction: Knee
Last Updated on September 28, 2026
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