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Poor soft tissue balance in total knee arthroplasty (TKA) often results in patient dissatisfaction and reduced joint longevity. Patella-in-place balancing (PIP is a novel technique which aims to restore native collateral ligament behavior without collateral ligament release, while restoring post-operative patellar position. This study aimed to assess the effectiveness of this novel technique through a detailed ex vivo biomechanical analysis by comparing post-TKA tibiofemoral kinematics and collateral ligament behavior to the native cond