The purpose was to measure the morphology of the proximal tibia at different levels for consideration of tibial tray design and placement. The morphology was analysed in 51 knees at 10, 15,20, and 25 mm below the centre of the lateral tibial plateau. Surface rotation was measured by fitting an ellipse on the resection surface. The anteroposterior (AP), mediolateral (ML), medial AP (MAP) and lateral AP (LAP) dimensions were also measured. The resection surface showed internal rotation of 22.9 degrees from the 10 mm level to the 25 mm level. More distally, the ML AP and MAP/LAP ratios showed significant changes. Surgeons should pay attention to morphological changes for patients with gross tibial bone defects in primary and revision total knee arthroplasty. (C) 2015 Elsevier Inc. All rights reserved.