MRI-based anatomic study of 104 normal knees characterizing the distal femoral epicondyles — their morphology, gender-specific dimensions, and precise distance relationships to the knee joint line — to establish reliable intraoperative landmarks for femoral component positioning in primary and revision TKA.
In revision TKA where bone loss obscures landmarks, measure the transepicondylar width intraoperatively and multiply by 0.36 (medial) or 0.32 (lateral) to approximate the correct joint line — and always reference the medial epicondylar sulcus rather than the ridge high point for rotational alignment.
The wide variance in posterior condylar angle (0°–8.2°) means you cannot reliably rely on a fixed 3° posterior condylar reference alone without verifying against the epicondylar axis.
MRI-based anatomic study of 104 normal knees characterizing the distal femoral epicondyles — their morphology, gender-specific dimensions, and precise distance relationships to the knee joint line — to establish reliable intraoperative landmarks for femoral component positioning in primary and revision TKA.
In revision TKA where bone loss obscures landmarks, measure the transepicondylar width intraoperatively and multiply by 0.36 (medial) or 0.32 (lateral) to approximate the correct joint line — and always reference the medial epicondylar sulcus rather than the ridge high point for rotational alignment.
The wide variance in posterior condylar angle (0°–8.2°) means you cannot reliably rely on a fixed 3° posterior condylar reference alone without verifying against the epicondylar axis.