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Alignment radiographs of 174 extremities in patients undergoing total knee arthroplasty were measured to determine the variability in valgus cut angle (VCA) and the anatomical factors that affect the VCA necessary to restore the mechanical axis. The VCA averaged 5.6° ± 1.0° with a range of 2° to 9°. With the 3different methods of defining the anatomical axis of the femur, 30% to 51% of patients required...