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good so i'll give you a few insights in kinematic alignment i'll be very balanced so i will not necessarily take fully the pro on kinematic alignment this is my disclosure and for this talk it is relevant as i will briefly discuss an implant i think we are facing a paradox most of us when we operate on patients for total knees deal with deformed knees and it seems logical that we should correct the deformity on the other hand many of us say that totally orthoplasty is soft tissues operation so the surgery should stay within the soft tissue limits that is logical the premise for the study that steve has just shown you is the fact that we assume that ligaments do not shrink and we think that as we deal with this patient we restore the volume on the medial side will put the patient back into his native alignment which will not necessarily be a neutral alignment so we looked at a cohort of 250 subjects steve referenced the paper already and found that about one-thirds of th

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