An example of normal axial rotation in which the lateral femoral condyle rotates more posteriorly than the medial condyle (ie, internal tibial rotation) during flexion is shown. (Reprinted with permission from Dennis DA, Komistek RD, Mahfouz MR, Walker SA, Tucker A. A multicenter analysis of axial femorotibial rotation after total knee arthroplasty. Clin Orthop Relat Res. 2004;428:180–189.)