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The relationships between intraoperative tibiofemoral rotational angles and clinical outcomes were also evaluated in the two groups. The intraoperative tibial internal rotational angle relative to the femur during knee flexion was significantly larger in the nonelderly group (13.5°) than in the elderly group (9.0°). The intraoperative tibial internal rotational angle showed a positive correlation with the pain subscale of KOOS only in the nonelderly group. Intraoperative rotational kinematics and its influence on clinical outcomes were