Inclusion Criteria:

• Include all patients who are surgical candidates for primary TKA with unilateral osteoarthritis.
• All eligible male or female patients between the ages of 20 years to 100 years old.
• All included study participants must be able to give an informed consent.

Exclusion Criteria:

• Significant femoral or tibial deformity due to congenital or traumatic etiologies, inflammatory arthritis, post-septic arthritis, osteomyelitis, prior infection of knee joint, osteoporosis, dislocated or fragmented patella.
• The presence of infections, highly communicable diseases (e.g., AIDS), active tuberculosis, venereal disease, hepatitis.
• Significant neurological or musculoskeletal disorders or disease that may adversely affect normal gait or weight bearing.
• Presence of previous prosthetic knee replacement devices (of any type).
• Metastatic disease.
• Psychiatric illness.
• Drug or alcohol abuse.
• Body mass index (BMI) > 40 kg/m^2.