Total knee arthroplasty (TKA) is a cost effective and successful operation for patients with end-stage arthritis of the knee.1,2 In the United States, the demand for TKA is projected to rise by 673% to 3.48 million procedures by 2030, and revision TKA by 601%.3 Furthermore, the demand for TKA among patients aged < 65 years is predicted to be > 50% of the TKAs which are performed by 2016.3 An ageing population, a rising prevalence of risk factors such as obesity, and the necessity to maintain...