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Assessment of the Radii of the Medial and Lateral Femoral Condyles in Varus and Valgus Knees with Osteoarthritis

8100 Timberlake, Suite F, Sacramento, CA 95758. E-mail address for S.M. Howell: sebhowell{at}mac.com
Mechanical and Aeronautical Engineering, University of California at Davis, 2132 Bainer Hall, One Shields Avenue, Davis, CA 95616-5294

Investigation performed at Mechanical and Aeronautical Engineering, University of California at Davis, Davis, California

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from commercial entities (Biomet Sports Medicine and OtisMed, Inc.).

Methods A magnetic resonance imaging scan was obtained with use of a biplanar, rotational alignment protocol in a consecutive series of subjects with end-stage osteoarthritis prior to total knee arthroplasty. The alignment protocol oriented the scanning plane so that both condyles were imaged in a plane perpendicular to the primary femoral axis of the knee about which the tibia flexes and extends. The study included 155 varus knees and forty-four valgus knees. Radii were calculated from the area of the best-fit circle overlaid from 10° to 160° on the subchondral corticocancellous bone interface of the medial and lateral femoral condyles. The radius of a condyle was the average of the radii on four adjacent images that showed the femoral condyle with the largest curvature.

Results In the 155 varus knees, the radius of the lateral condyle was an average of 0.1 mm larger than that of the medial condyle (p = 0.003). In the forty-four valgus knees, the radius of the lateral condyle was an average of 0.2 mm larger than that of the medial condyle (p < 0.006). There was a strong association between the radii of the medial and lateral femoral condyles in both the varus (r² = 0.9210) and the valgus (r² = 0.9129) knees.

Conclusions As determined by imaging of the femoral condyles perpendicular to the primary femoral axis of the knee, the asymmetry between the radii of the medial and lateral femoral condyles in varus and valgus knees with end-stage osteoarthritis was 0.2 mm, which is small enough to be considered clinically unimportant when aligning a total knee prosthesis.

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