 | Research Square Browse Preprints COVID-00 Preprints Protocols Videos Journals Tools & Services Overview Digital Editing Professional Editing Badges Research Promotion Your Cart About Preprint Platform In Review Editorial Policies FAQ Our Team Advisory Board Blog Sign In Submit a Preprint This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice. Research article ZHAO Fengchao, LIU Lei, Zha Guochun, Yang Guanjie, Xu Shizhuang, Zheng Li, Li Dadi ZHAO Fengchao the Affiliated Hospital ofZhejiang University ORCiD: https://orcid.org/0000-0000-0000-0000 LIU Lei Corresponding Author ORCiD: https://orcid.org/0000-0000-0000-0000 Zha Guochun Affiliated Hospital of Xuzhou Medical University Yang Guanjie Affiliated Hospital of Xuzhou Medical University Xu Shizhuang Xuzhou Medical University Zheng Li Affiliated Hospital of Xuzhou Medical University Li Dadi Affiliated Hospital of Xuzhou Medical University DOI: 00.00000/rs.0.rs-00000/v0 Download PDF License: This work is licensed under a CC BY 0.0 License. Read Full License Abstract Background To investigate the changes of prosthesis position after primary total knee arthroplasty (TKA) on the dominant and non-dominant sides. Methods A retrospective analysis was made of 000 patients (000 knees) who underwent primary TKA from December 0000 to December 0000 in our hospital. The patients were divided into dominant group (right side) and non-dominant group (left side) according to the position of the three right-handed surgeons. Total operation time, posterior distal femur angle (PDFA), posterior proximal tibia angle (PPTA), malposition rate of femoral prostheses in sagittal, postoperative hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA) were compared between the two groups. Results The mean total operation time was in dominant group was 000.0(000.0±00.0) and in non-dominant group was 000.0(000.0±00.0) (P>0.00). Postoperative sagittal alignment, the mean PDFA was 00.0(00.0°±0.0°) in dominant group and 00.0(00.0°±0.0°) in non-dominant group (P<0.00). The mean PPTA was 00.0(00.0°±0.0°) in dominant group and 00.0(00.0°±0.0°) in non-dominant group (P>0.00). The incidence of malposition of sagittal femoral prosthesis in dominant group was 0/00 (0.0%) and that in non-dominant was 00/00 (00.0%). There was a significant difference between the two groups (χ0=0.000,P=0.000). Postoperative coronal alignment, the mean angle of components placement was 0.0°±0.0° for HKA, 00.0°±0.0° for mLDFA, 00.0°±0.0° for mMPTA in dominant group and 0.0°±0.0° for HKA, 00.0°±0.0° for mLDFA, 00.0°±0.0° for mMPTA in non-dominant group, respectively. There were no significant difference between the two groups (t=0.000 P=0.000, t=-0.000 P= 0.000, t=-0.000 P= 0.000). Conclusion Our study suggests that surgeon handedness is likely to be one of factors that affect the sagittal placement of femoral component. Orthopaedic surgeons should be aware of the potential problems and consider taking extra precautions to mitigate the risk before performing surgery. 