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07° per degree of axial rotation and 0.22° per degree of posterior slope (linear regression, R2 0.99). Conclusion While the effect of axial malalignment has been studied, the impact on coronal alignment is not known. Our results indicate that the direction of the cutting guide and malalignment in axial rotation alter coronal plane alignment and can increase the incidence of outliers. Cite this article Bone Joint J 2020;102-B(6 Supple A)43-48.Aims Aseptic loosening of the tibial component is a frequent cause of failure in prim