The overwhelming success of total knee arthroplasty (TKA) has rapidly increased its utilization. 1,2) Initially, the procedure was largely meant to relieve pain and preserve mobility in the elderly, but it has expanding the spectrum of usage to include a younger, demanding population. Its significant effect on improving quality of life has made enormous socioeconomic impact. To optimize outcomes of TKA, there have been rapid advances in each aspect of the surgery, including preoperative patient optimization, precise surgical technique, effective pain control, and expeditious rehabilitation. 2) Even with these changes, 10%−15% of patients remain dissatisfied. 3) One of the reasons for dissatisfaction is presumed to be altered kinemat

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