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RESULTS Multivariate analysis showed that increasing the patellar component size decreased the risk of patellar tilt by 37% (p  less then  0.001). Placing the femoral component at 3° of external rotation decreased the risk of patellar tilt by 67% (p  less then  0.001). Secondary analysis showed better clinical outcomes in the NPT group, especially regarding global satisfaction, and KSS objective and subjective scores. The revision for any cause was less in the NPT group (p = 0.019). The cause for TKA revision was related to the patellar in