A 70-year-old woman had suffered from right knee pain without any history of trauma or infection for 30 years. The pseudoanterior drawer sign was positive, as were posterior sagging and the posterior drawer sign. Radiographic findings identified the Kellgren-Lawrence grade as 4. We performed total knee arthroplasty（TKA） under the method of first using the cutting guide to make a posterior condylar cut, the size of which was bigger than that of the implant. This technique was very useful to cut the tibia side in this case because the neurovascular bundle was very close to the posterior tibial margin. Good clinical and radiographic outcomes were observed without any complications
at one year after TKA.