Knee resection and gap balancing instruments and techniques for kinematic alignment

A method for coupling a tibial cut guide and a femoral cut guide for performing a total knee arthroplasty with kinematic alignment of a femur and a tibia, the method comprising:

• attaching a tibial positioning device to a tibial cut guide;
• attaching the tibial positioning device to a 4-in-1 femoral cut guide;
• adjusting a position of the tibial cut guide relative to the 4-in-1 femoral cut guide to form parallel resections;
• and
• immobilizing the tibial cut guide relative to the 4-in-1 femoral cut guide using the tibial positioning device.

A method of performing resections for kinematic alignment in a total knee arthroplasty, the method comprising:

• positioning a knee joint such that a tibia is located in a flexion position relative to a femur;
• resecting a distal end of the femur to remove distal-most portions of medial and lateral condyles to form a distal resected surface;
• coupling a femoral cutting guide to the femur such that a flat posterior surface of the femoral cutting guide is flush with the distal resected surface;
• coupling a tibial cutting guide to a tibial positioning device, the tibial cutting guide including a proximal tibial cutting guide surface;
• coupling the tibial positioning device to the femoral cutting guide such that the flat posterior surface of the femoral cutting guide is perpendicular to the proximal tibial cutting guide surface;
• and
• resecting a proximal portion of the tibia using the proximal tibial cutting guide surface.