PurposeMalrotation of the femoral component after primary total knee arthroplasty (TKA) is one of the most important problems leading to painful TKA requiring revision surgery. MethodsA comprehensive systematic review of the literature was performed to present current evidence on how to optimally place the femoral component in TKA. Several landmarks and techniques for intraoperative determination of femoral component placement and examination of their reliability were analyzed. Results2806 articles were identified and 21 met the inclusion criteria. As there is no unquestioned gold standard, numerous approaches are possible which come along with specific advantages and disadvantages. In addition, imaging modalities and measurements regarding postoperative femoral component rotation were also investigated. Femoral component rotation measurements on three‐dimensional (3D) reconstructed computerised tomography (CT) images displayed intraclass correlation coefficients (ICC) above 0.85, significantly better than those performed in radiographics or two‐dimensional (2D) CT images. Thus, 3D CT images to accurately evaluate the femoral prosthetic component rotation are recommended, especially in unsatisfied patients after TKA. ConclusionThe EKA Femoral Rotation Focus Group has not identified a single best reference method to determine femoral component rotation, but surgeons mostly prefer the measured resection technique using at least two landmarks for cross‐checking the rotation. Level of evidenceIII.

This paper presents a case of a massive giant cell tumor of bone (GCTB), Campanacci and Enneking type III, in an atypical location at the proximal end of the radius. In type I and II cases, surgical treatment is the treat­ment of choice: curettage of the lesion, replacement of bone defects with bone grafts or cement. Advanced type III changes frequently require segmental resection and joint reconstruction. In our patient, a segmental resection of the proximal third of the radius and infiltrated surrounding soft tissues was performed without reconstruction of the radius. A good clinical outcome without a relapse has been noted at one year post surgery.